PLOS global public health最新文献

{"title":"Correction: Do women with a previous unintended birth subsequently experience missed opportunities for postpartum family planning counseling? A multilevel mixed effects analysis.","authors":"Otobo I Ujah, Jason L Salemi, Rachel B Rapkin, William M Sappenfield, Ellen M Daley, Russell S Kirby","doi":"10.1371/journal.pgph.0004912","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004912","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1371/journal.pgph.0002570.].</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004912"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602476","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":"\"I want to help my body\": Acceptability of malaria chemoprevention among children with sickle cell anaemia and their caregivers in Malawi and Uganda.","authors":"Sarah Svege, Siri Lange, Bjarne Robberstad, Joseph Rujumba","doi":"10.1371/journal.pgph.0004056","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004056","url":null,"abstract":"<p><p>Patients with sickle cell anaemia (SCA) are at risk of severe illness and death if infected by malaria, and lifelong prophylaxis is recommended to individuals in malaria endemic regions. Although its efficacy is declining due to parasite resistance, the antimalarial drug Sulphadoxine-Pyrimethamine (SP) is still given to patients with SCA in several countries of sub-Saharan Africa. A clinical trial was performed to compare SP with Dihydroartemisinin-Piperaquine (DP) for malaria chemoprevention in children with SCA in Uganda and Malawi. This paper describes a study on acceptability which was nested within the trial. To explore views on malaria chemoprevention and the proposed treatment regimens, 29 focus group discussions were conducted with children above 10 years of age with SCA and caregivers of children with SCA. The discussions were transcribed and translated to English before coding and reflexive thematic analysis. Participants from the DP arm reported a reduced number of sick events and hospital admissions while they were in the trial, and ranked DP above SP in terms of perceived effectiveness. Although concerns were raised about initial side effects, a high pill burden, and the unpleasant smell and taste of tablets, most participants were willing to continue long-term administration of DP due to its observed or experienced health benefits. Despite positive attitudes towards the use of weekly DP, monthly dosing was frequently suggested as a better option as it would lower the pill burden and expand the time interval between treatment courses. To mitigate transport costs and time spent away from school and work, most participants preferred a period of two months or longer between drug refill visits at the hospital. During routine care visits, counselling about the importance of accurate dosing and ongoing adherence should be provided to ensure sustainable and successful use of malaria chemoprevention among children with SCA.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004056"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602475","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":"Physical activity prevalence and associated factors among Zimbabwean undergraduate students: A cross-sectional study.","authors":"Lynne T Makuzo, Paidamoyo Monalisa Chakandinakira, Ruramayi Nicole Shanu, Panashe Sithole, Israella H T Mugova, Leovellah Murape, Hardlife Muchinani, Isaac Munyoro, Shalom R Doyce, Tariro Dee Tunduwani, Clayton Zimunya, Beatrice K Shava, Anotida R Hove, Sidney Muchemwa, Webster Mavhu, Dixon Chibanda, Jermaine M Dambi","doi":"10.1371/journal.pgph.0004866","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004866","url":null,"abstract":"<p><p>Many university students worldwide are physically inactive, negatively affecting their mental health and academic performance. Group-based physical activity (GBPA) can effectively increase physical activity levels. This study assessed the physical activity (PA) levels and related factors, knowledge, attitudes and perceptions of GBPA in a cross-sectional study of 1217 Zimbabwean undergraduates from three universities. Data were collected using the International Physical Activity Questionnaire (IPAQ), Exercise Benefits Barriers Scale (EBBS) and Knowledge, Attitudes and Perceptions (KAP) questionnaires. Data were analysed using logistic regression at α = 0.05. About 75.7% of the students engaged in moderate-to-high PA. Not playing sports [AOR 0.20;95%CI (.10 -.40)], a negative perception of exercise benefits [AOR 0.63;95%CI (.47 -.34)], studying a non-health program [AOR 1.4;95%CI (1.04- 1.94)], female [AOR 1.94;95%CI (1.45 - 2.56)], and first years (AOR 0.62; 95%CI (.43 -.91)] were associated with low PA. Only 41.9% reportedly engaged in GBPA. Not playing sports [AOR 3.06;95%CI (1.81; 5.17)] and negative perception of exercise benefits [AOR 2.69;95%CI (2.06; 3.50)] predicted low knowledge of GBPA. Lower PA levels [AOR:.684; 95% CI (.518;.903)], not playing sports [AOR 3.2 - 95%CI (1.92; 5.31)], negative perception of exercise benefits [AOR 3.34;95%CI (2.60:4.38)] and taking alcohol [AOR 0:63;95%CI (.48;.83)] were linked with negative attitudes and perceptions towards GBPA. While university students demonstrate high PA, knowledge, positive attitudes, and favourable perceptions toward GBPA, their participation in GBPA is low. Interventions targeting the promotion of GBPA among university students are necessary to achieve the benefits of physical activity.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004866"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602480","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":"\"I just wanted to be like everyone else…\": Qualitative exploration of women's perspectives on female genital mutilation/cutting and its potential abandonment in Somalia.","authors":"Zamzam I A Ali, Mervat Alhaffar, Natasha Howard","doi":"10.1371/journal.pgph.0004571","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004571","url":null,"abstract":"<p><p>Somalia has the highest estimated prevalence of female genital mutilation/cutting (FGM/C) globally. However, significant literature gaps exist on associated knowledge and contextual factors within the country, particularly among affected women. This study thus aimed to explore Somali women's perspectives about FGM/C and its potential abandonment in Somalia. We conducted an exploratory qualitative study, informed by critical feminist and social norms theories. Data from 20 semi-structured remote interviews with women in Somalia were analysed thematically using abductive coding. We generated three themes of normative expectations and social control, patriarchal influence and gendered power, and FGM/C support and abandonment. Women demonstrated detailed knowledge of FGM/C procedures and consequences, sharing personal experiences of living with the effects of FGM/C on their physical, mental, and sexual health. Most supported continuation of \"milder\" 'gudniinka sunnah' FGM/C, rather than abandoning the tradition. However, 'gudniinka sunnah' described several types of cutting, some which fit the World Health Organization typology of Type-IV (pricking, scraping) and others Type-I (removing part/all of the external clitoris), while 'gudniinka fircooniga' (Type-III) - though still occurring - was universally described negatively. While acknowledging potential harms, women expressed the need for more religious and scientific clarity before changing their generally supportive opinions of 'sunnah' FGM/C. Discussing socio-cultural and religious reasons for this preference, women described social norms of femininity and how awareness interventions affected their understanding of 'severe' FGM/C and could help responses against FGM/C in Somalia. While all FGM/C types are negatively associated with women's health and wellbeing, Type-IV is least understood. Although women opposed Type-III, they supported continuing Type-I/Type-IV as 'sunnah' FGM/C. Reasons for this practice are rooted deeply in Somali culture and require active engagement of a range of community stakeholders to enact meaningful changes. Health education can contribute to changing attitudes towards FGM/C in Somalia but is insufficient on its own, potentially benefitting from interventions to change social norms.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004571"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602474","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":"Record linkage without patient identifiers: Proof of concept using data from South Africa's national HIV program.","authors":"Khumbo Shumba, Jacob Bor, Cornelius Nattey, Dickman Gareta, Evelyn Lauren, William Macleod, Matthew P Fox, Adrian Puren, Koleka Mlisana, Dorina Onoya","doi":"10.1371/journal.pgph.0004835","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004835","url":null,"abstract":"<p><p>Linkage between health databases typically requires patient identifiers such as names and personal identification numbers. We developed and validated a record linkage strategy to combine administrative health databases without identifiers for South Africa's public sector HIV program. We linked CD4 counts and HIV viral loads from South Africa's TIER.Net with the National Health Laboratory Service (NHLS) database for patients receiving care between 2015-2019 in Ekurhuleni District (Gauteng Province). Linkage variables were result value, specimen collection date, facility of collection, year and month of birth, and sex. We used three matching strategies: exact matching on exact values of all variables, caliper matching allowing a ± 5 day window on result date, and specimen barcode matching using unique specimen identifiers. A sequential linkage approach applied specimen barcode, followed by exact, and then caliper matching. Exact and caliper matching were validated using barcodes (available for 34% of records in TIER.Net) as a \"gold standard\". Performance measures were sensitivity, positive predictive value (PPV), share of patients linked, and percent increase in data points. We attempted to link 2,017,290 laboratory test results from TIER.Net (523,558 unique patients) with 2,414,059 NHLS test results. Exact matching achieved 69.0% sensitivity and 95.1% PPV. Caliper matching achieved 75% sensitivity and 94.5% PPV. Sequential linkage matched 41.9% using specimen barcodes, 51.3% through exact matching, and 6.8% through caliper matching, for 71.9% (95% CI: 71.9, 72.0) of test results matched overall, with 96.8% (95% CI: 96.7, 97.1) PPV and 85.9% (95% CI: 85.7, 85.9) sensitivity. This linked 86.0% (95% CI: 85.9, 86.1) of TIER.Net patients to the NHLS (N = 1,450,087), increasing laboratory results in TIER.Net by 62.6%. Linkage of TIER.Net and NHLS without patient identifiers attained high accuracy and yield without compromising privacy. The integrated cohort provides a more complete laboratory test history and supports more accurate HIV program indicator estimates.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004835"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602481","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":"Effect of diet video-drama and telephone messages on improving parental knowledge and diet diversity of malnourished children in Kenya: A randomised controlled trial.","authors":"Beatrice C Mutai, Fredrick Were, Jalemba Aluvaala, Grace John-Stewart, E Maleche-Obimbo","doi":"10.1371/journal.pgph.0004818","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004818","url":null,"abstract":"<p><p>Severe acute malnutrition (SAM) accounts for 1 million deaths globally each year. Ready-to-use Therapeutic Food (RUTF), recommended for treatment, is often replaced with low-nutrient home foods. We sought to determine the effect of enhanced caregiver counselling, using a dramatized video with contextualized demonstrations of local high-nutrient food (video-drama) and telephone messages on high-nutrient foods (SMS), on children's dietary diversity scores (DDS), weight gain, and caregiver knowledge. This randomised trial enrolled 213 severely malnourished children and caregivers at Mbagathi Hospital in Nairobi. Children were randomised to 3 study arms: standard of care (SOC) (children received RUTF, caregivers received routine nutrition counselling); intervention arm A (caregivers watched the video-drama at enrolment, 1- and 6-weeks post-enrolment plus SOC); and intervention arm B (caregivers received weekly SMS, watched the video-drama plus SOC). Primary outcome was DDS, secondary outcomes were weight gain and caregiver knowledge. Median DDS, mean rate of weight gain and caregiver knowledge were compared between trial arms using Kruskal-Wallis and ANOVA tests, respectively. Children's median age at enrolment was 12 months (IQR 8.0, 16.0), 50.7% were female, 74.6% were breastfeeding and 78.9% were on RUTF. Median caregiver age was 28 years (IQR 24.5, 32.0) and 98% were female. Post-intervention, children in arms A and B had significantly higher median DDS at 5 (IQR 4, 5) versus 4 (IQR 3, 5) in SOC arm (p < 0.001)]. Mean caregiver knowledge was significantly higher in arm A (4.53[±1.17)] and arm B (4.27[±1.04]) compared to 3.77(±0.91) in SOC (p < 0.001). Mean rate of weight gain was similar across study arms [7.60 g/kg/day in intervention arms, 7.30 g/kg/day for SOC (p-value 0.31)]. Video-drama enhanced SOC counselling of local high-nutrient foods, improved children's DDS and caregiver knowledge, but did not improve short-term weight gain. Weekly SMS did not provide additional benefits to the video-drama.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004818"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602477","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":"Iron deficiency anaemia in mothers and infants with high inflammatory burden: Prevalence and profile in a South African birth cohort.","authors":"Jessica E Ringshaw, Michal R Zieff, Sadeeka Williams, Chloë A Jacobs, Zayaan Goolam Nabi, Thandeka Mazubane, Marlie Miles, Donna Herr, Daniel C Alexander, Melissa Gladstone, Vanja Klepac-Ceraj, Laurel J Gabard-Durnam, Dima Amso, William P Fifer, Derek K Jones, Dan J Stein, Steven C R Williams, Kirsten A Donald","doi":"10.1371/journal.pgph.0004174","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004174","url":null,"abstract":"<p><p>The scarcity of epidemiological data on anaemia in low- and middle-income countries, coupled with contrasting approaches to the assessment of iron status with inflammation, represent critical research gaps. This study characterised the prevalence and profile of iron deficiency anaemia, including adjustment for inflammation, in mothers and infants from South Africa. Mother-child dyads (n = 394) were recruited (2021-2022) for the Khula birth cohort in Cape Town. Haematological metrics, iron metrics, and inflammatory biomarkers were obtained from mothers antenatally and 3-6 months postnatally, and infants 3-18 months postnatally. The extent to which inflammation impacted iron deficiency was assessed using two methods; Method A: higher serum ferritin thresholds for classifying iron status in participants with inflammation (World Health Organisation), Method B: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anaemia (BRINDA) regression which corrects serum ferritin based on inflammatory biomarker concentrations. Prevalence of maternal anaemia was 34.74% (107/308) in pregnancy and 22.50% (54/240) in mothers at 3-6 months after childbirth. Of their infants, 46.82% (125/267) and 48.10% (136/283) were anaemic by 6-12 months and 12-18 months, respectively. Using Method A, the prevalence of maternal iron deficiency (regardless of anaemia), increased from 18.35% (20/109) to 55.04% (60/109) in pregnancy, and from 11.97% (28/234) to 46.58% (109/234) postnatally. Similarly, using Method B, maternal iron deficiency prevalence increased to 38.53% (42/109) in pregnancy, and 25.21% (59/234) postnatally. In infants at 12-18 months, the prevalence of iron deficiency increased from 19.79% (19/96) to 31.25% (30/96) and 32.29% (31/96) using Methods A and B, respectively. Approximately half of anaemia cases in mothers antenatally (50%; 20/40) and postnatally (45.10%; 23/51), and infants at 12-18 months (55.56%; 10/18), were attributable to iron deficiency. This is one of the first studies reporting the extent to which iron deficiency anaemia may be underestimated if inflammation is unaccounted for in South African mothers and infants.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004174"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602478","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":"Keeping the \"R\" in LARC (long-acting reversible contraception): Measuring client-centered implant removal services in sub-Saharan Africa.","authors":"Celia Karp, Katherine Tumlinson, Brooke W Bullington, Linnea A Zimmerman, Leigh Senderowicz","doi":"10.1371/journal.pgph.0004478","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004478","url":null,"abstract":"<p><p>As the use of subdermal contraceptive implants increases across sub-Saharan Africa, the need for person-centered removal services is more critical than ever to safeguard reproductive autonomy. In 2016, Christofield and Lacoste proposed eight conditions for client-centered implant removal, yet the extent to which these conditions have been assessed in large-scale surveys remains unexamined. Our mapping exercise collates survey information from three large data collection platforms fielded in sub-Saharan Africa, including the Demographic and Health Surveys (DHS), Performance Monitoring for Action (PMA), and the Service Availability and Readiness Assessment (SARA), utilizing questionnaire tools implemented among women, health facilities, providers, and clients to map existing data sources against these conditions. Our findings reveal that four of the eight conditions are fully captured, three are partially captured, and one is entirely absent within current population or facility-based surveys. Specifically, among the six facility-based conditions: the three conditions completely captured include the availability of supplies (condition 2), systems for managing difficult removals (condition 3), and the provision of counseling and reinsertion options (condition 5); two conditions partially captured include competent and confident providers (condition 1) and affordability for clients (condition 7), and the one condition that remained absent was measurement systems for monitoring of removal data (condition 8). Among the two individual-level conditions, timely and proximate service (condition 4) was partially captured and knowledge and awareness of where to go for removal (condition 6) was fully captured. Nearly a decade after Christofield and Lacoste proposed these client-centered conditions, the lack of consistent measures for client-centered implant removal poses significant barriers to understanding service accessibility and women's reproductive experiences. To protect the reproductive autonomy of individuals who use long-acting reversible contraceptive (LARC) methods and desire timely discontinuation, it is imperative to develop and implement standardized metrics for their removal.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004478"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602479","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":"Implementing community-based interventions for the management of chronic conditions in low- and middle-income countries: A scoping review of qualitative evidence.","authors":"Syreen Hassan, Nancy Kagwanja, Brahima Diallo, Robinson Oyando, Pablo Perel, Anthony Etyang, Benjamin Tsofa, Ellen Nolte","doi":"10.1371/journal.pgph.0004860","DOIUrl":"10.1371/journal.pgph.0004860","url":null,"abstract":"<p><p>The rising prevalence of chronic diseases in low- and middle-income countries (LMICs) poses significant challenges to already overburdened health systems. Community-based interventions are recognised as effective strategies for managing these conditions. However, implementing such interventions faces barriers that can hinder their effectiveness. This scoping review aims to assess qualitative studies examining barriers and facilitators to implementing community-based interventions for chronic disease management in LMICs. We searched six databases for studies published between 2013-2024. Eligible studies were those with a qualitative design that explored implementation challenges and facilitators of community-based interventions. Data were thematically analysed and interpreted using the Socio-Ecological Model (SEM) to capture multi-level influences on implementation. Eighteen studies were included, covering interventions in 13 LMICs. We identified four levels of influencing the implementation of chronic condition management interventions: individual (service users and providers), community, health system/policy, and interpersonal. Barriers at the individual level included privacy concerns, misconceptions about CHW roles, and a preference for traditional medicine. Facilitators included strong CHW motivation, often driven by personal experiences with the conditions they managed. Community-level support, particularly from local leaders and sensitization events, enhanced intervention acceptance. At the health system level, training quality and role recognition of CHWs were critical, while barriers included excessive workload and insufficient infrastructure. Interpersonal relationships, especially gender dynamics and attitudes of facility-based workers towards CHWs, also influenced implementation outcomes. The quality of qualitative evidence varied, with many studies lacking clear objectives and data collection or analysis frameworks. Effective implementation of community-based interventions for chronic disease management in LMICs requires addressing both systemic and interpersonal barriers. Future interventions should emphasise structured community engagement, comprehensive training, and better integration with healthcare systems. Additionally, improving the methodological rigor of qualitative research is essential for gaining deeper insights into the complex factors that influence the success and sustainability of these interventions.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004860"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593144","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":"Knowledge and reporting of adverse events following childhood immunization (AEFI) among health workers and caregivers at Mengo Hospital (2021), Kampala, Uganda: A mixed-methods study.","authors":"Benjamin Watyaba, Lucy Chimoyi, Ivana Knezevic, Oliver Ombeva Malande, Hamza Kalutte, Henry Bazira, Faith Kewaza, Florence Adong, Oliver Nankonyoli, Bernard Kikaire","doi":"10.1371/journal.pgph.0004827","DOIUrl":"10.1371/journal.pgph.0004827","url":null,"abstract":"<p><p>Vaccines used in National Immunization Programmes (NIPs) are known to be safe and effective if used correctly, however, no vaccine is completely risk-free as adverse events occasionally occur after immunization. The World Health Organization (WHO) recommends adverse event following immunization (AEFI) surveillance for all vaccines as a critical tool to monitor safety and address potential concerns. However, the factors contributing to Uganda's inability to meet global vaccine safety indicators remain unclear. This study assessed the level of knowledge and reporting of AEFI of children among healthcare workers and caregivers at Mengo Hospital, Kampala. A cross-sectional mixed-methods study involving three focus group discussions, each consisting of five caregivers, eight key informant interviews with healthcare workers (HCWs) and 388 face-to-face interviews with caregivers was carried out. Caregivers accompanying their children for their routine vaccination visits were invited to participate in the study. We descriptively summarized data using measures of central tendency, dispersion, and frequencies. Crude and adjusted measures of association between predictors and AEFI reporting were assessed using Pearson's Chi-square test, and binary logistic regression analysis respectively. Thematic analysis was used to identify behavioral, personal, and social patterns influencing knowledge and reporting of adverse events following immunization among caregivers and HCWs. Approximately one-third of caregivers (130, 33.5%) reported that their children experienced an AEFI and reported it to a healthcare facility. Significant predictors of AEFI reporting included having a secondary education (aOR = 3.56, 95% CI: 1.12-11.30), tertiary education or higher (aOR = 8.52, 95% CI: 2.09-34.81), being older than 35 years (aOR= 18.77; 95% CI: 2.34-150.60) and unmarried (aOR = 3.27, 95% CI: 1.51-7.12). While most HCWs had good AEFI knowledge, they lacked awareness of the national reporting system. Strengthening training for HCWs and raising awareness among caregivers is essential to improve AEFI surveillance.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004827"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593145","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}