PLOS global public health最新文献

{"title":"Enhancing tuberculosis care in the private sector: Role of innovative private sector engagement model under programmatic settings in India.","authors":"Sandhya Gupta, Raghuram Rao, Kathirvel Soundappan, Kedar Mehta, Suseendar Shanmugasundaram, Akash Ranjan Singh, Hitesh Verma, Alok Mathur, Rajendra Panduranga Joshi, Prabhadevi Ravichandran, Urvashi Balbir Singh","doi":"10.1371/journal.pgph.0006333","DOIUrl":"https://doi.org/10.1371/journal.pgph.0006333","url":null,"abstract":"<p><p>India's private sector plays a crucial role in the country's tuberculosis (TB) healthcare landscape, with >50% of patients seeking initial care from private providers. Recognizing this critical role, the National Tuberculosis Elimination Program implemented and scaled up an innovative private sector engagement model, Patient Provider Support Agency (PPSA), in over 200 districts of the country in 2023 to improve TB care in the private sector. A cross-sectional study was conducted to assess the role of PPSA in improving TB care services among private-sector patients in 2023. We compared districts with PPSA and without PPSA for their TB notification, treatment timeliness, key quality-of-care indicators and treatment outcomes from the private sector at the national level. Data for private sector notification from Ni-kshay (web-enabled TB patient management system) was analyzed. In 2023, districts supported by PPSA (n = 204) recorded an average private sector TB notification rate of 106 per 100,000 and achieved 99.7% of the set target, compared to 529 districts without PPSA, which reported a rate of 45 per 100,000 and reached only 80% of the target. The pretreatment loss to follow-up (2% vs 4%) and the treatment initiation delay >7 days (5% vs 10%) were lower in districts with PPSA. They also reported improved TB care services- comorbidity testing (HIV and diabetes), bank detail linkage for receiving financial support and treatment success with PPSA support. However, districts with PPSA showed lower coverage of upfront nucleic acid amplification testing (17% vs 22%), drug susceptibility testing (21% vs 25%) and uptake of government-supplied drugs (22% vs 33%) compared with districts without PPSA. The PPSA model improved private sector TB notification and reduced treatment delays nationally; however, strategic expansion by focusing on quality-oriented TB care services and their link to results-based financing is essential to maximize its efficiency and overall impact on private sector TB care.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 5","pages":"e0006333"},"PeriodicalIF":2.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857719","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":"COVID-19 vaccine acceptance and uptake in Indonesia, Nepal, and Vietnam: Key lessons from a qualitative study.","authors":"Ida Ayu Sutrisni, Vy Pham-Tram, Manish Duwal, Ha Nguyen Thanh, Diana Timoria, Aria Kekalih, Dewi Friska, Ragil Dien, Claus Bogh, Phong Nguyen Thanh, Raph L Hamers, Abhilasha Karkey, Sonia Lewycka, Mary Chambers, Jennifer Ilo Van Nuil","doi":"10.1371/journal.pgph.0006381","DOIUrl":"https://doi.org/10.1371/journal.pgph.0006381","url":null,"abstract":"<p><p>Since 2019, the WHO has included vaccine hesitancy among the top ten threats to global health. Additionally, there is global disparity in vaccine availability and access. As part of a mixed methods study that explored COVID-19 vaccine acceptance and access across Indonesia, Nepal and Vietnam from December 2021 to June 2022, we conducted 67 in-depth interviews with purposively selected community members from both urban and rural settings. We used thematic analysis to analyse and interpret the interviews. Dominant aspects that influenced COVID-19 vaccine acceptance in Indonesia, Nepal, and Vietnam included risk perception, trust, logistics and social norms. These aspects were context-specific and fluid as the pandemic course changed over time. Analysis of COVID-19 vaccination rollout in these settings provide prominent lessons reflecting the importance of embracing contextual norms and building and maintaining trust as early as possible for enhanced acceptance of newly introduced vaccines. Understanding and embracing social norms in specific contexts could also support interventions for specific audiences, with more targeted approaches and methods. Continued discussions to delve deeper into contextual social norms and trust is imperative to support acceptance of newly introduced vaccines.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 5","pages":"e0006381"},"PeriodicalIF":2.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857775","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":"Bacterial diversity and antibiotic susceptibility profile of the isolates from public vehicles in Butwal Sub-Metropolitan City, Rupandehi, Nepal.","authors":"Ram Bahadur Khadka, Balram Neupane, Khimdhoj Karki, Saksham Pokharel","doi":"10.1371/journal.pgph.0006421","DOIUrl":"https://doi.org/10.1371/journal.pgph.0006421","url":null,"abstract":"<p><p>Public transportation systems are vital for urban mobility but are susceptible to bacterial contamination due to high passenger density, frequent shared surface contact,minimal ventilation, and unsatisfactory cleaning practices promoting transmission of pathogenic and antibiotic resistant bacteria.,The main aim of this study was to explore the bacterial diversity associated with selected public vehicles and determine the antibiotics susceptibility patterns of bacterial isolates.A descriptive cross-sectional study was carried out from July 2023 to July 2024 at Paschimanchal Bus Terminal Stop, Butwal Sub-Metropolitan City, Rupandehi, Nepal. A total of 324 swabs were gathered from high-contact surfaces in AC buses, micro buses, and wingers using systematic sampling. Standard laboratory methods were used to identify bacterial cultures and their antibiotic susceptibility.Out of 324 surface swabs from 81 public vehicles, 262 (80.86%) showed bacterial growth. Among 262 isolates 148 (56.48%) were Gram positive and 114 (43.51%) Gram-negative. Predominant Gram positive isolates were CoNS 72 (27.48%), S.aureus 52 (19.84%) and Bacillus spp. 21 (8.02%), while Gram negative included E.coli 32 (12.21%), Klebsiella spp. 26 (9.92%) and Pseudomonas spp. 21 (8.02%). CoNS (44.44%, 32/72) and S.aureus (42.31%, 22/52) were significantly more frequent in Micro buses (P < 0.05). High antibiotic sensitivity was found for Gentamicin (100%, 12/12 for Micrococcus sp.; 97.22%, 70/72 for CoNS) and Meropenem (100%, 26/26 for Klebsiella spp.). Resistance was highest to Cetriaxone (100%, 9/9 for Citrobacter spp.) and Amoxicillin-clavulanic acid (69.2%. 18/26 for Klebsiella spp.) The extensive bacterial contamination present indicates an immediate need for better hygiene practices, improved cleaning methods, and public education to limit the microbial hazards associated with public transportation. Reduced sensitivity to commonly prescribed antibiotics, such as erythromycin in Staphylococcus aureus, indicates emerging antimicrobial resistance, posing greater risks to public health through limited treatment options and the spread of resistant strainsin the community.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 5","pages":"e0006421"},"PeriodicalIF":2.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857764","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":"Estimating the impact of the RTS,S/AS01 malaria vaccine in Benin: A mathematical modelling study.","authors":"Sena V Alohoutade, Rachel Hounsell, Codjo Dandonougbo, Rock Aikpon, Jules Degila, Sheetal Silal","doi":"10.1371/journal.pgph.0005543","DOIUrl":"https://doi.org/10.1371/journal.pgph.0005543","url":null,"abstract":"<p><p>Malaria constitutes a major public health burden in sub-Saharan Africa. It remains a key health concern and the leading cause of death in children under five in Benin. Since October 2021, the World Health Organization has recommended the use of malaria vaccines for the prevention of Plasmodium falciparum malaria in children living in malaria endemic areas, prioritizing areas of moderate and high transmission in sub-Saharan Africa. However, with the exception of Ghana, there is a scarcity of studies modelling the potential impact of the RTS,S/AS01 vaccine in the context of West Africa. A compartmental mathematical model was developed to estimate clinical and severe malaria cases averted in children under five with the primary series of the RTS,S/AS01 malaria vaccine in Benin. Over a period of 10 years, scenarios involving vaccine introduction at different coverage levels alongside the use of long-lasting insecticidal nets were modelled to assess the impact of the RTS,S/AS01 vaccine on malaria transmission. The combination of childhood malaria vaccination at a coverage similar to that of the third dose of diphtheria, tetanus, and pertussis (DTP3) vaccine, along with the current use of nets, is projected to result in a 40% reduction in malaria clinical cases and deaths among children under five years old, compared to using nets alone, from 2025 to 2034. However, if the introduction of a malaria vaccine has the unintended consequence of decreased net use, cumulative benefits may be offset. A 1.5-fold decrease in the use of nets is projected to result in an increase in malaria burden. This modelling exercise concludes that childhood vaccination is expected to avert clinical and severe cases of malaria and is an additional tool to advance malaria control efforts in Benin but potential unintended consequences of a reduction in net usage may reduce these gains.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 5","pages":"e0005543"},"PeriodicalIF":2.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857777","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":"Comment on: Legal but persecuted: The cultural politics of therapeutic abortion in Latin America.","authors":"Silvana Matassini Eyzaguirre, Magaly Blas","doi":"10.1371/journal.pgph.0006448","DOIUrl":"https://doi.org/10.1371/journal.pgph.0006448","url":null,"abstract":"","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 5","pages":"e0006448"},"PeriodicalIF":2.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857769","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: \"When a man is stressed, it replicates in the house\": Kenyan women's perspectives on the influence of male partners on perinatal mental health among women affected by HIV.","authors":"Hellen Moraa, Joan Mutahi, Winnie Atieno, Grace John-Stewart, John Kinuthia, Manasi Kumar, Mary Marwa, Ben Odhiambo, Felix Abuna, Jillian Pintye, Dalton Wamalwa, Gabrielle O'Malley, Keshet Ronen, Irene Njuguna, Anna Larsen","doi":"10.1371/journal.pgph.0006451","DOIUrl":"https://doi.org/10.1371/journal.pgph.0006451","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1371/journal.pgph.0006047.].</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 5","pages":"e0006451"},"PeriodicalIF":2.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857795","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":"Health facility preparedness for early detection of symptomatic cancer in Southern Africa: A multi-centre cross-sectional study.","authors":"Tasleem Ras, Sarah Day, Bothwell Guzha, Valerie A Sills, Suzanne E Scott, Fiona M Walter, Jennifer Moodley","doi":"10.1371/journal.pgph.0004825","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004825","url":null,"abstract":"<p><p>Early detection and diagnosis of cancer in African contexts is challenging. Health services should identify people with symptoms suggestive of cancer, refer timeously, and implement diagnostic processes efficiently. This requires the resources and infrastructure to provide these services. This study, the first in Southern Africa, reports on the availability of these services across referral pathways in four provinces of two Southern African countries, South Africa and Zimbabwe. As part of the African Awareness of Cancer and Early Diagnosis (AWACAN-ED) programme, we conducted a quantitative cross-sectional study, from February to September 2023 at primary care (PC), secondary and tertiary (ST) level public sector health facilities. PC's role is to identify and refer patients, while the definitive diagnosis mostly occurs at ST level. Data were collected on the availability of staff, infrastructure, diagnostic services, referral pathways and community engagement, and analysed descriptively. A total of thirty-four (N = 34) facilities were included. Twenty-two (n = 22) were PC facilities, serving a population of 1,068,177, with a nurse-to-1000-person ratio of 0.46, and doctor-to-1000-person ratio of 0.04. Twelve (n = 12) ST facilities were included, serving a population of 18,750,387, with a nurse-to-1000-person ratio of 0.42, and doctor-to-1000-person ratio of to 0.06. PC and ST facilities differed in availability of adequate communication infrastructure (40% vs 42%); patient transport systems (50% vs 100%); cervical smears/visual inspection (77% vs 100%) and colorectal clinical assessment (9% vs 58%). Mammography was not available at any Zimbabwean facilities. There was low availability of clinical protocols in primary care for cervical (30%) and breast (9%) cancer, and none for colorectal cancer. Community engagement activities focused on breast and cervical cancer. This study identifies areas for improving early cancer diagnosis and provides a baseline for quality improvement interventions in facility infrastructure and referral pathways.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 5","pages":"e0004825"},"PeriodicalIF":2.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857742","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":"Multi-stakeholder perspectives on gender-based violence in marital relationships: A qualitative study in rural India.","authors":"Soumya Singh, Aneel Brar, Urvita Bhatia, Devika Gupta, Abhijit Nadkarni","doi":"10.1371/journal.pgph.0006364","DOIUrl":"https://doi.org/10.1371/journal.pgph.0006364","url":null,"abstract":"<p><p>In India, an estimated 41% of women report experiencing domestic violence in their lifetime and up to 28% report violence during pregnancy. Our study aims to understand local perceptions/attitudes towards GBV and lived experiences of GBVvictimisation and perpetration in marital relationships in rural Rajasthan. We conducted a focus group discussion with community health workers (n = 7) and interviews with young married men (n = 17) and women (n = 21), and local government officials (n = 2). The data was analysed using thematic analysis with triangulation conducted across methods and researchers. Our findings reveal that women experience multiform violence, including physical, sexual, and economic violence. In the continuum of GBV, violence stems from everyday conditions of disempowerment produced through early marriage and reproduction, norms of hegemonic masculinity, and community norms that normalise violence against women. These conditions of disempowerment lead to women's isolation through control of mobility and surveillance through technology, setting the stage for further violence to occur. Violence prevention efforts in the region must follow a multi-level approach to reduce child marriage through community education and improved enforcement of legislation, enhance reporting and identification alongside help-seeking behaviours through formal or informal channels, transform rigid gender norms, and leverage key actors in the family system such as the in-laws or matchmakers as potential agents of change.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 5","pages":"e0006364"},"PeriodicalIF":2.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857762","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":"Quantifying the impact of social activities on SARS-CoV-2 transmission using Google mobility reports.","authors":"Felix Günther, Hilde Kjelgaard Brustad, Arnoldo Frigessi, Tom Britton","doi":"10.1371/journal.pgph.0006368","DOIUrl":"https://doi.org/10.1371/journal.pgph.0006368","url":null,"abstract":"<p><p>We developed a new state-space model to investigate which social activities had biggest impact on the spread of SARS-CoV-2. Our analyses suggest that data from four categories of the Google community mobility reports capture an important share of transmission-relevant social activity. The analyses were based on reported hospitalizations and data on vaccinations, temperature, and virus strains. We applied our model to Sweden and Norway on a regional level over 17 months, and to the regions of Berlin and Bavaria in Germany over 10 months. Most results were shared for all three countries: Activity in the four social settings explained between 40-65% of all infections; Public transport appeared as an important setting for infections; and the transmission potential drops by around 40% during summer as compared to winter. However, the analyses for Germany differ in that Retail and recreation was the second activity setting dominating transmission whereas it was contacts at the Workplace in Norway and Sweden, showing how our model is able to adapt to specific cases. Transmissions not captured by the Google data may happen in other settings, in particular in households. In future pandemics, our method could be used in real time to guide more targeted intervention strategies.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 5","pages":"e0006368"},"PeriodicalIF":2.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857765","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":"Intensive longitudinal follow-up of cisgender and transgender women engaged in sex work during the three months following initiation of daily oral PrEP: A series of case-studies with mixed-method assessments.","authors":"Laia J Vazquez Guillamet, Jorge Valencia, Pablo Ryan, Mariano Matarranz, Guillermo Cuevas-Tascón, Miguel Angel Del-Olmo-Morales, Laura Laguna, Natalia Casanueva, Cristina Viladomiu, Lynn T Matthews, Jeffrey V Lazarus, Guillaume Chevance","doi":"10.1371/journal.pgph.0006056","DOIUrl":"10.1371/journal.pgph.0006056","url":null,"abstract":"<p><p>Pre-exposure prophylaxis (PrEP) usage among cisgender and transgender women sex workers in Europe is low. This mixed-methods study examined the daily experiences of woman sex workers using PrEP, with emphasis on understanding the dynamic process of initiating and sustaining PrEP adherence. We employed an intensive longitudinal design with daily assessments of self-reported use of daily oral PrEP, side-effects, condom use, and number of clients over a 3-month period, followed by in-depth exit qualitative interviews that also explored PrEP initiation, communication with sex workers and clients, and stigma. Convenience sampling was used to enroll 15 sex workers (12 transgender and 3 cisgender women) presenting to a PrEP clinic in Madrid between November 2022 and January 2023, all from Latin America. We collected 1266 daily survey responses and 13 interviews. Quantitative results showed that average PrEP adherence was above 70%, with missed doses being randomly distributed, and that condom use and number of clients did not significantly change during the study period. Qualitative results showed that the main reason to start PrEP was concern about condom rupture and/or removal by clients. Facilitators of PrEP adherence included personal motivation, creation of daily routines, and use of personal alarms. Barriers to PrEP adherence included side effects from PrEP and its coingestion with other substances, and changes in daily routine related to work, and travel. Strict prescription protocols represented an additional layer of difficulty. Secondary gains included a feeling of empowerment and the opportunity to opt for condom substitution for economic benefit, personal pleasure, or the desire to foster a trusting relationship with long-standing clients. This involved few selected encounters and did not impact overall number of clients. PrEP communication was limited by PrEP and HIV stigma. We found a complex interplay of individual, occupational, and structural factors shaping early PrEP adherence among participants.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 5","pages":"e0006056"},"PeriodicalIF":2.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847101","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}