PLOS global public health最新文献

{"title":"Prioritizing countries for TB vaccine readiness research using a global stakeholder-centric approach.","authors":"Michelle M Gill, Rupali Limaye, Puck T Pelzer, Mike Frick, Andrew D Kerkhoff","doi":"10.1371/journal.pgph.0004668","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004668","url":null,"abstract":"<p><p>The promise of new tuberculosis (TB) vaccine candidates prompts the need for research on vaccine demand and health system readiness to help ensure effective and equitable vaccine deployment. We developed an approach to prioritizing countries for TB vaccine readiness research by combining stakeholder preferences, elicited through best-worst scaling (BWS) with an analytical hierarchy process (AHP) framework. We conducted a self-administered electronic survey targeting TB vaccine stakeholders involved in vaccine development, advocacy, and implementation across 23 of the 24 USAID TB priority countries, and key stakeholders working globally. The survey included BWS to determine the relative importance of 17 criteria for country selection. Stakeholders were recruited using an existing email list, a 'snowball' approach, and TB experts' recommendations. In a series of 13 choice tasks, respondents selected the most and least important criteria from four randomly generated criteria. The weights derived through BWS for each criterion were combined with country-specific scores for each criterion using publicly available data to determine the overall prioritization score for each country. Of 427 stakeholders, 115 (26%) completed the survey; 88% were from TB priority countries. Sixteen of 17 criteria were identified as 'important' using BWS. Overall country TB burden (weight = 11.1) and TB-related political will (weight = 10.3) were the most important, followed by burden of TB-related deaths (weight = 7.9), health systems strength (weight = 7.5), and adult COVID-19 coverage (weight = 7.4). The five countries with the highest prioritization scores were in sub-Saharan Africa. Three of them were selected alongside the highest-scoring country from South Asia, Europe and Central Asia, and East Asia as priority research settings in pursuit of regional diversity. This study demonstrates the successful use of the AHP combined with BWS, as a practical and transparent approach for prioritizing countries for TB vaccine readiness research which could be applied to support other evidence-based funding decisions in global public health.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 8","pages":"e0004668"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and experiences with differentiated service delivery of HIV care in Kisumu County, Kenya: A mixed methods study, 2014-2021.","authors":"Francesca Odhiambo, Raphael Onyango Mando, Jayne Lewis-Kulzer, A Rain Mocello, Maurice Aluda, Edwin Mulwa, Appolonia Aoko, Paul Musingila, Elizabeth Bukusi, Craig R Cohen","doi":"10.1371/journal.pgph.0004481","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004481","url":null,"abstract":"<p><p>The adoption of the test and treat policy by the World Health Organization (WHO) in 2015 led to an unprecedented increase in the number of people living with HIV (PLHIV) enrolling into HIV treatment, thereby increasing the burden on HIV service delivery. To compensate, WHO endorsed the Differentiated Service Delivery (DSD) approach to reduce the burden on the health care system and therefore support attainment of the UNAIDS 95-95-95 goals by 2030. This study examined clinical outcomes among clients enrolled in the DSD models and examined health care worker and client experiences of the DSD approach. A client-level pre-post study was conducted in 14 Ministry of Health (MOH) facilities in Kisumu County from October 2014 - March 2021 to examine retention and viral load suppression (<1000 copies/mL) in a cohort of stable clients aged 20 years and above at three time points: immediately preceding DSD start (pre-DSD; 2014-2016), 12 months post-DSD implementation (midline), and 24 months post-DSD (endline). Focus group discussions (FGDs) were conducted to assess DSD experiences among a sample of adult clients and health care workers. Findings from the pre-post analysis showed a significant increase in retention at 12 months (99.2%) and 24 months (98.9%) compared to pre-DSD (86.4%; p < 0.001). The predominant themes shared by clients and healthcare workers in FGDs were high satisfaction with DSD due to the efficiency of services, improved staff attitudes, and reduced clinic workload. Clients also expressed a strong preference for facility-based models owing to perceived stigma and privacy concerns associated with community DSD models. This study provides important insights on the promising effectiveness of DSD models on sustained retention on ART and viral suppression and the acceptability of this modality for client-centered HIV care.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 8","pages":"e0004481"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional variations in child health deprivation and its associated factors in Nigeria.","authors":"Victor Chima, Funmilola F Oyinlola, Joseph A Kupoluyi, Segun Tekun, Ifeyinwa U Anyanyo","doi":"10.1371/journal.pgph.0003796","DOIUrl":"https://doi.org/10.1371/journal.pgph.0003796","url":null,"abstract":"<p><p>Child health deprivations differ by socio-cultural differences and some demographic and socio-economic factors. Deprivation may be more pronounced by the geo-political zones/regions in Nigeria given the differences in their socio-cultural, education, religion, and economic particularly between the North and the South geo-political zones. Thus, this study examined regional variations in child health deprivation and its associated factors in Nigeria. The 2021 Nigeria Multiple Indicator Cluster Survey (MICS) was used for the study. A weighted sample size of 26,639 under-five children was analysed using STATA SE Version 14. Data were analysed using different descriptive statistics to examine regional variations in child health deprivation. Pearson's Chi-square and Binary logistic regression were performed to determine associated factors influencing child health deprivation in Nigeria at p < 0.05 level of significance. Results showed that nearly all children (96%) experience at least a deprivation in healthcare with a slight variation across regions in Nigeria. Child health deprivation was higher in the Northern regions than in the Southern regions. Interestingly, when compared to those who were not deprived, the Southwest region had the highest percentage of children who were not deprived (5%). The study also found lower odds of child health deprivation between children aged four (4) (OR = 0.65, 95%CI [0.50-0.85], p < 0.05), whose household head had tertiary education (OR = 0.19, 95%CI [0.13-0.28], p < 0.05), and from richest wealth index (OR = 0.06, 95%CI [0.04-0.10], p < 0.05). The study concludes that health deprivation is high among children in Nigeria irrespective of region of residence. Household and other factors have effects on the deprivation of healthcare for children according to the region of residence. This accentuates the need for a comprehensive review of policies and strategies related to health insurance schemes, and vaccination programs targeting under-five children in Nigeria.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 8","pages":"e0003796"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A peer-educator driven approach for sampling populations at increased mpox risk in the Democratic Republic of the Congo: Implications for surveillance and response.","authors":"Sydney Merritt, Megan Halbrook, Yvon Anta, Patrick K Mukadi, Emmanuel Hasivirwe Vakaniaki, Tavia Bodisa-Matamu, Lygie Lunyanga, Cris Kacita, Jean Paul Kompany, Jean-Claude Makangara-Cigolo, Michel Kenye, Sifa Kavira, Thierry Kalonji, Sylvie Linsuke, Emile Malembi, Daniel Mukadi-Bamuleka, Liliane Sabi, Candice Lemaille, Marie Clotilde Inaka, Nicola Low, Lisa E Hensley, Nicole A Hoff, Robert Shongo, Jason Kindrachuk, Anne W Rimoin, Placide Mbala-Kingebeni","doi":"10.1371/journal.pgph.0003857","DOIUrl":"https://doi.org/10.1371/journal.pgph.0003857","url":null,"abstract":"<p><p>The epidemiological risk factors associated with mpox acquisition and severity in the Democratic Republic of the Congo (DRC) are changing. We assessed perceived mpox risk, and behavioral, clinical and sexual histories among key populations at risk of acquisition through sexual contact. Here, we describe a sampling strategy to enroll participants considered to be at increased risk for mpox infection - men who have sex with men (MSM) and sex workers (SW) - in three urban centers in the DRC. Through the combined approach of time-location sampling with peer educators and respondent-driven sampling, a mixed cohort of 2826 individuals including self-identified MSM (n = 850), SW (n = 815), both MSM and SW (n = 118) and non-MSM, non-SW individuals (n = 1043) were enrolled in Kinshasa, Kinshasa province, Kenge, Kwango province, and Goma, North Kivu province, from March-August 2024. Of these, over 90% were reached through peer educators. The odds of sampling SW individuals were higher at bars/clubs than traditional health facilities. Conversely, the odds of enrolling MSM were highest at selected health facilities. Modifications to the sampling approach were introduced in Kenge and Goma, but these did not affect the enrollment of MSM or SW participants. Ultimately, the selection of, and collaboration with, well-integrated peer educators was the most important facet of this sampling strategy. As the definitions of at-risk populations continue to change for mpox, we demonstrate a functional approach to quickly surveying otherwise hard-to-reach groups for both public health surveillance activities and response.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 8","pages":"e0003857"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-based solutions for chronic disease management during natural disasters: A systematic review.","authors":"Aditi Iyer, Arthur Bookstein, Giselle Kim, Justine Po","doi":"10.1371/journal.pgph.0004997","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004997","url":null,"abstract":"<p><p>Despite rapid increases in both the burden of chronic disease and climate change-driven extreme weather events globally, the need to jointly address these crises remains largely overlooked. Chronic diseases require ongoing and often specialized care, which natural disasters disrupt by increasing physiological stressors and disrupting access to healthcare facilities, food, shelter and medications. Community-based solutions can mitigate these health risks, especially in low-resource settings and among historically underserved populations. This systematic review aimed to identify key recommendations for community-based interventions that aid with chronic disease management during extreme weather events. A comprehensive search strategy was used to yield 46 eligible studies from 266 search results from Embase, PubMed and Google Scholar. Articles were included if they discussed chronic diseases, community-based solutions and natural disasters and excluded if they were not English-language and/or not published in a peer-reviewed journal. Articles were assessed and selected using PRISMA guidelines, and their quality was assessed using the Joanna Briggs Institute Critical Appraisal Tools. The final sample of studies represented 19 countries and consisted of four quantitative, 35 qualitative and seven mixed-method studies. Minimal quantitative data was a key limitation of this review and topic, which requires further research. From the selected studies, a narrative synthesis approach was used to derive nine themes of solutions. Findings reflected the highest number of interventions and recommendations targeting patient education, continuity of medication management, stakeholder collaboration and digital health.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 8","pages":"e0004997"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and predictors of kidney dysfunction among people living with HIV in Tanzania.","authors":"Daniel Msilanga, Elizabeth Msangi","doi":"10.1371/journal.pgph.0005011","DOIUrl":"https://doi.org/10.1371/journal.pgph.0005011","url":null,"abstract":"<p><p>As people living with HIV (PLHIV) in sub-Saharan Africa live longer due to widespread access to antiretroviral therapy (ART), the burden of non-communicable diseases, including kidney dysfunction (KD) has increased. Existing studies in Tanzania show varying prevalence and inconsistent predictors of KD, highlighting the need for updated, context-specific data. We conducted a cross-sectional sub-analysis of data from a larger study assessing point-of-care creatinine testing. PLHIV aged ≥18 years attending the HIV clinic at Temeke Regional Referral Hospital (TRRH) in Dar es Salaam from 5th January to 30th March 2025 consented to participate were included. Renal function was assessed using serum creatinine measured via the Jaffé method, and eGFR was calculated using the CKD-EPI 2021 equation. Kidney dysfunction was defined as eGFR < 60 mL/min/1.73 m². Logistic regression was used to identify predictors. Ethical approval was obtained from National Institute for Medical Research (NIMR) under reference number NIMR/HQ/R.8a/Vol.IX/4695. Among 358 participants, the majority were female (66.2%) and aged ≥45 years (62.3%). The prevalence of KD was 15.6% with 24.6% reporting at least one comorbid condition. In multivariable analysis, the presence of comorbidities was the only independent predictor of KD (aOR: 3.93; 95% CI: 1.85-8.36; p < 0.001). Only 5.3% of participants with reduced eGFR had a prior diagnosis of kidney disease. Kidney dysfunction is a significant but underdiagnosed comorbidity among PLHIV in urban Tanzania. Comorbid conditions, especially hypertension, are major contributors to reduced kidney function and integrating non-communicable disease screening and management into HIV care is needed to enable earlier detection and improve long-term renal outcomes.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 8","pages":"e0005011"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Laws for health and care worker protection and rights: A study of 182 countries.","authors":"Matthew M Kavanagh, Adi Radhakrishnan, Vishakh Unnikrishnan, Giorgio Cometto, Catherine Kane, Eric A Friedman, Varsha Srivatsan, Luis Gil Abinader, James Campbell","doi":"10.1371/journal.pgph.0005007","DOIUrl":"10.1371/journal.pgph.0005007","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1371/journal.pgph.0003767.].</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0005007"},"PeriodicalIF":2.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762585","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":"Patient related factors associated with antiretroviral therapy defaulting among the youth accessing HIV care services in Mzimba, Malawi.","authors":"Paul Isaac Kasalu, Matthews Lazaro, Idesi Chilinda","doi":"10.1371/journal.pgph.0004507","DOIUrl":"10.1371/journal.pgph.0004507","url":null,"abstract":"<p><p>Antiretroviral therapy (ART) defaulting is a serious problem among youth accessing Human immunodeficiency virus (HIV) care services in Malawi. It leads to development of drug resistance, treatment failure and increased client mortality. This study aimed at assessing patient factors influencing ART defaulting amongst youth living with HIV enrolled on ART in Mzimba District. A quantitative, case-control design was employed, enrolling 411 youths living with HIV (n = 137 cases and n = 274 controls) attending an HIV care clinic. The cases and controls were allotted to the ART clinics proportionally to their number of ART clients. Random sampling techniques were used to recruit both ART defaulters and non-defaulters. Data were collected using a structured questionnaire and analyzed using Statistical Package for Social Sciences (SPSS) version 20.0. Descriptive statistics provided counts, frequencies, proportions, and ranges, while inferential statistics established associations between dependent and independent variables. Patient related factors associated with ART defaulting include: Participants age (p-value: 0.046, Cramer's V: 0.2, OR: 0.663, 95% CI: 0.439-0.902), forgetting appointment date (p-value: < 0.001, OR: 4.213, 95% CL: 2.289-7.755), experiencing ART side effects (p-value: < 0.001, OR: 0.438, 95% CL: 0.286-0.672), taking other drugs apart from ART (p-value 0.008, OR: 0.059, 95% CL: 0.007-0.479). ART defaulting was also associated with presence of a psychological disorder among the participants (SRQ statement 7_8) (p-value <0.001, OR: 22.119, 95% CL: 10.81-45.26) and having suicidal ideas (p-value <0.001, OR: 0.111, 95%CL: 0.051-0.241). Seventeen percent (17%) of the youths had psychological disorders, 10% suicidal thoughts, 20.0% anxiety, 12.4% felt worthless, 19.2% troubled mind, 24.8% headache and abdominal discomfort (23.8%). This study sought to identify patient factors associated with ART defaulting in Mzimba district. Participant's age, forgetfulness, ART side effects, taking other drugs and having psychological disorders influence ART defaulting. We recommend that addressing these patient needs, may reduce defaulting to ART.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004507"},"PeriodicalIF":2.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762626","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":"Socio-ecological determinants of multiple anthropometric failures among under-five children: A systematic review and meta-analysis of observational studies.","authors":"Biniyam Sahiledengle, Paul Russell Ward, Bereket Duko, Kingsley Emwinyore Agho, Lillian Mwanri","doi":"10.1371/journal.pgph.0005008","DOIUrl":"10.1371/journal.pgph.0005008","url":null,"abstract":"<p><p>The composite index of anthropometric failure (CIAF) offers a comprehensive measure of the overall burden of undernutrition in children, extending beyond the traditional anthropometric indices to better capture the co-occurrence of multiple anthropometric deficits. Despite its growing use, evidence on the determinants of CIAF remains fragmented and inconclusive. This systematic review and meta-analysis aimed to identify and synthesize the determinants of CIAF among under five children. A comprehensive search of nine major databases was conducted, including MEDLINE (PubMed), Embase (Ovid), Scopus, CINAHL, ProQuest, ScienceDirect, Global Index Medicus, the Cochrane Library, and Google Scholar. Determinants were categorized using a socio-ecological model across intrapersonal, interpersonal, and community levels. Random-effects meta-analyses were conducted to generate pooled odds ratios (ORs), and heterogeneity was assessed using the I² statistic and Cochran's Q test. Subgroup analyses, sensitivity testing, and publication bias assessment were also performed. Of 6,816 records identified, 56 studies met inclusion criteria (encompassing a total of 1,029,452 under five children). Intrapersonal factors significantly associated with higher odds of CIAF included male sex (OR: 1.17, 95% CI:1.04-1.30), older child age (OR: 1.50, 95% CI: 1.42-1.59), diarrhea (OR: 1.18, 95% CI: 1.08-1.29), fever (OR: 1.08, 95% CI: 1.04-1.13), anemia (OR: 1.22, 95% CI: 1.16-1.29), low birthweight (OR: 2.07, 95% CI: 1.51-2.83), and poor dietary diversity (OR: 1.11, 95% CI: 1.06-1.17). Interpersonal and community-level determinants significantly associated with increased odds of CIAF included low maternal education, maternal unemployment, household poverty, larger family size, food insecurity, and use of unimproved drinking water. We identified key modifiable risk factors associated with CIAF among under five children at different levels, including inadequate dietary intake, childhood morbidity, household food insecurity, limited maternal education, and poor access to safe water. These findings emphasize the need for comprehensive, multi-level interventions that address modifiable risk factors across individual, household, and community levels to reduce childhood multiple anthropometric failures.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0005008"},"PeriodicalIF":2.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762627","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 link between child dietary diversity and child anemia: The power of colorful plates.","authors":"Amare Abera Tareke, Ahmed Juhar Temam, Addis Alem, Zeleke Geto, Ebrahim Msaye Assefa, Mohammed Derso Bihonegn, Mekonin Belete, Gashaw Abebe, Seid Mohammed Abdu, Altaseb Beyene Kassaw, Gosa Mankelkl, Melese Shenkut Abebe, Hussen Abdu","doi":"10.1371/journal.pgph.0005001","DOIUrl":"10.1371/journal.pgph.0005001","url":null,"abstract":"<p><p>Nutritional anemias are the most common causes of anemia worldwide, and the extent is greater in the sub-Saharan African (SSA) region. Dietary diversification is among the strategies to prevent anemia due to nutrient deficiencies. There is a lack of evidence on the effect of dietary diversity on anemia, particularly in children. We evaluated the influence of child dietary diversity on anemia among children aged 6-23 months. We used the recent nationally representative cross-sectional surveys from 23 SSA countries. A child with inadequate dietary diversity (treated group) was matched with a child with adequate dietary diversity (control group) based on selected covariates and calculated propensity scores to match 11,742 children in both groups. The effect of child dietary diversity on child anemia was evaluated using independent t-tests, binomial regression, and linear regression. Children with inadequate dietary diversity had a -0.082g/dl (95% CI = -0.137 - -0.027) and p-value < 0.005 lower hemoglobin concentration than children with adequate dietary diversity. Children with inadequate dietary diversity had a 3% increased risk of anemia, compared to children having adequate dietary diversity, RR = 0.97, (95% CI = 0.95 - 0.99) and p-value < 0.05. A one-unit increase in child dietary diversity score was associated with a 0.05 g/dl increase in child hemoglobin (β = 0.05, 95% CI: 0.03 - 0.06), with p-value of < 0.001. One unit increase in dietary diversity score among lower dietary diversity groups resulted in a 0.12 g/dl, (95% CI 0.09 - 0.15g/dl) increase in child hemoglobin level (p-value < 0.001). Inadequate dietary diversity significantly increases the risk of anemia in children. Adequate dietary diversity in children resulted in small but significantly higher mean hemoglobin concentration. To effectively combat anemia in children it is imperative to implement multifaceted interventions that promote dietary diversity and improve food security.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0005001"},"PeriodicalIF":2.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755323","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}