PLOS global public health最新文献

{"title":"Predictors of metabolic syndrome among teachers in under-resourced schools in South Africa: Baseline findings from the KaziHealth workplace health intervention.","authors":"Nandi Joubert, Larissa Adams, Jan Hattendorf, Jan Degen, Danielle Dolley, Annelie Gresse, Ivan Müller, Siphesihle Nqweniso, Nicole Probst-Hensch, Harald Seelig, Peter Steinmann, Rosa du Randt, Uwe Pühse, Jürg Utzinger, Markus Gerber, Cheryl Walter","doi":"10.1371/journal.pgph.0004681","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004681","url":null,"abstract":"<p><p>Non-communicable diseases (NCDs) account for most of global deaths, with rising prevalence in low-and middle-income countries. Metabolic syndrome (MetS) is a cluster of interrelated NCD risk factors, including obesity, dyslipidaemia, hypertension, and hyperglycaemia, that amplify NCD risk. Four leading modifiable factors driving NCDs are physical inactivity, tobacco and alcohol use, and an unhealthy diet. Teachers in under-resourced schools face significant health challenges, with their wellbeing often overlooked in South Africa. The prevalence and severity of MetS, adherence to physical activity guidelines, and associations with modifiable NCD risk factors were assessed. This study, part of the 'KaziBantu: Healthy Schools for Healthy Communities' project, included 168 teachers (aged 21-72, mean = 47 years) from 8 under-resourced schools in Gqeberha, South Africa. Data collection included MetS markers, device-measured physical activity, tobacco and alcohol use, and total fat, saturated fat, sugar, and sodium intake. Covariates included age, sex, race, education, and household income. MetS was observed in 58% of participants, with central obesity (79%) being the most prevalent component, followed by hypertension (59%). The largest proportion of participants (26%) had 3 MetS components, followed by 4 components (20%), while 12% had all 5 components. Nearly half (44%) of teachers were physically inactive and 53% exceeded total fat intake recommendations. Bayesian multilevel logistic regression revealed key predictors of MetS: age (per year increase; odds ratio[OR]=1.15, 95% credible interval[CrI] [1.07, 1.24]) and high daily total fat intake (OR=3.37, 95%CrI [1.03, 11.96]) were positively associated, while hours spent in moderate-to-vigorous intensity physical activity per week (OR=0.73, 95%CrI [0.55, 0.95]) and higher monthly household income (OR=0.14, 95%CrI [0.02, 0.72]) were protective. Addressing physical inactivity and unhealthy diets through tailored interventions is crucial to reducing MetS prevalence and improving the health of teachers working in low-resourced settings. Effective solutions should empower healthier lifestyles while tackling structural barriers to health equity.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0004681"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251220","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":"Cofactors of earlier uptake of modern postpartum family planning methods in Kenya.","authors":"Nancy M Ngumbau, Damaris Kimonge, Julia C Dettinger, Felix Abuna, Ben Odhiambo, Laurén Gómez, Anjuli D Wagner, Mary M Marwa, Salphine Watoyi, Emmaculate Nzove, Jillian Pintye, Jared M Baeten, John Kinuthia, Grace John-Stewart, Cyrus Mugo","doi":"10.1371/journal.pgph.0004353","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004353","url":null,"abstract":"<p><p>There are limited data on uptake of postpartum family planning (FP), particularly in high HIV prevalence settings. We assessed the timing of modern postpartum FP initiation and the cofactors of earlier uptake using longitudinal data from a clinical trial conducted in Kenya to assess two models of PrEP delivery among pregnant and postpartum women (NCT#03070600). Time to uptake of modern postpartum FP was estimated using survival analysis methods, and Cox proportional hazard models were used to determine cofactors of earlier uptake of modern postpartum FP. Among 4,191 women, median age was 24 years, 17% were aged 15-19 years, 88% were in a steady relationship, 50% intended to be pregnant and 75% were multigravida. The median time to resumption of sex was 8 weeks postpartum versus 24 weeks for uptake of postpartum FP. At 6 weeks postpartum, 42% of women had resumed sex, versus 12% who took up FP; at 14 weeks, 79% versus 38%; at 6 months, 88% versus 59%; and at 9 months, 91% versus 80%, respectively. Injectables and implants were the most common FP methods. Approximately 3.3% of all women became pregnant during the 9-month postpartum period. Being older and having ≤4children was associated with earlier uptake of modern postpartum FP. Women with lower education, primigravida, low social support, history of miscarriage/stillbirth, without a partner at enrolment, not residing with their partners, not receiving financial support from their partner and whose youngest child at enrolment was < 2years had later uptake of postpartum FP. Women who were ambivalent about their immediate previous pregnancy took up postpartum FP later than those who intended to be pregnant. Our findings underscore the importance of addressing the individual, interpersonal, social and obstetric factors associated with timeliness of postpartum FP uptake during the development and delivery of postpartum FP interventions, particularly in high HIV prevalence settings.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0004353"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251217","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":"\"I was so worried\": Experiences of parents whose infants were admitted to a neonatal care unit.","authors":"Nicholas Twijukye, Rose Chalo Nabirye, Julius N Wandabwa, Mary Aleni, David Mukunya, Joshua Epuitai","doi":"10.1371/journal.pgph.0004741","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004741","url":null,"abstract":"<p><p>Parents of infants admitted to a neonatal unit tend to experience emotional stress following admission of their infants in a neonatal unit. The study aimed to explore the experiences of parents whose infants were admitted to a neonatal care unit. We conducted a qualitative study based on strategies of the phenomenological method of inquiry. Participants were recruited at discharge at the neonatal unit. We obtained ethical clearance from the relevant authorities and analysed the data using Braun and Clarke's thematic framework. We interviewed ten parents (nine mothers and one father). Two themes were identified from the study: 1) sources of parental stress and 2) moderators of parental stress. Parents experienced emotional stress from fears related to the survival chances of their infants, disrupted domestic, economic duties, and challenges meeting the unexpected expenses during hospital admission. Admission to the neonatal unit was perceived to be stressful for parents due to the unfamiliar experience in the neonatal unit, challenges of space, inadequate social amenities, heat from the machines, and restrictive infection and prevention practices. Positive interaction and communication with the healthcare providers, improvement in the infant's condition, and the ability to adapt and adjust were perceived to moderate parental stress. Parents of infants admitted to a neonatal unit experienced stress for different reasons. Prioritising the psychosocial needs of parents through the development of family-centered care models and support programs is critical in improving the experiences of parents of infants admitted to neonatal units.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0004741"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251215","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":"How does policy modelling work in practice? A global analysis on the use of epidemiological modelling in health crises.","authors":"Liza Hadley, Caylyn Rich, Alex Tasker, Olivier Restif, Sebastian Funk","doi":"10.1371/journal.pgph.0004675","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004675","url":null,"abstract":"<p><p>This study examines the use and translation of epidemiological modelling by policy and decision makers in response to the COVID-19 outbreak. Prior to COVID-19, there was little readiness for global health systems, and many science-policy networks were assembled ad-hoc. Moreover, in the field of epidemiological modelling, one with significant sudden influence, there is still no international guidance or standard of practice on how modelled evidence should guide policy during major health crises. Here we use a multi-country case study on the use of epidemiological modelling in emergency COVID-19 response, to examine the effective integration of crisis science and policy in different countries. We investigated COVID-19 modelling-policy systems and practices in 13 countries, spanning all six UN geographic regions. Data collection took the form of expert interviews with a range of national policy/ decision makers, scientific advisors, and modellers. We examined the current use of epidemiological modelling, introduced a classification framework for outbreak modelling and policy on which best practice can be structured, and provided preliminary recommendations for future practice. Full analysis and interpretation of the breadth of interview responses is presented, providing evidence for the current and future use of modelling in disease outbreaks. We found that interviewees in countries with a similar size and type of modelling infrastructure, and similar level of government interaction with modelling reported similar experiences and recommendations on using modelling in outbreak response. From this, we introduced a helpful grouping of country experience upon which a tailored future best practice could be structured. We concluded the article by outlining context-specific activities that modellers and policy actors could consider implementing in their own countries. This article serves as a first evidence base for the current use of modelling in a recent major health crisis and provides a robust framework for developing epidemiological modelling-to-policy best practice.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0004675"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251219","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":"Coaching visits and supportive supervision for primary care facilities to improve malaria service data quality in Ghana: An intervention case study.","authors":"Amos Asiedu, Rachel A Haws, Wahjib Mohammed, Joseph Boye-Doe, Charles Agblanya, Raphael Ntumy, Keziah Malm, Paul Boateng, Gladys Tetteh, Lolade Oseni","doi":"10.1371/journal.pgph.0003649","DOIUrl":"https://doi.org/10.1371/journal.pgph.0003649","url":null,"abstract":"<p><p>Effective decision-making for malaria prevention and control depends on timely, accurate, and appropriately analyzed and interpreted data. Poor quality data reported into national health management information systems (HMIS) prevent managers at the district level from planning effectively for malaria in Ghana. We analyzed reports from a series of 3 data coaching visits conducted at 231 health facilities in six of Ghana's 16 regions between February and November 2021. The visits targeted health workers' knowledge and skills in malaria data recording, HMIS reporting, and how managers visualized and used HMIS data for planning and decision making. A before-after design was used to assess how data coaching visits affected data documentation practices and compliance with standards of practice, quality and completeness of national HMIS data, and use of facility-based malaria indicator wall charts for decision-making at health facilities. The percentage of health workers demonstrating good understanding of standards of practice in documentation, reporting and data use increased from 72 to 83% (p < 0.05). By the second coaching visit, reliability of HMIS data entry increased from 29 to 65% (p < 0.001); precision increased from 48 to 78% (p < 0.001); and timeliness of reporting increased from 67 to 88% (p < 0.001). HMIS data showed statistically significant improvement in data completeness (from 62 to 87% (p < 0.001)) and decreased error rate (from 37 to 18% (p < 0.001)) after completion of the coaching visit series. By the third coaching visit, 98% of facilities had a functional data management system (a 26-percentage-point increase from the second to third coaching visit, p < 0.0001), 77% of facilities displayed wall charts, and 63% reported using data for decision-making and local planning. There are few documented examples of data coaching to improve malaria surveillance and service data quality. Data coaching provides support and mentorship to improve data quality, visualization, and use, modeling how other malaria programs can use HMIS data effectively at the local level.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0003649"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251216","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":"Comparison between self-reported and pedometer-measured physical activity in Vietnamese adolescents: A reliability and agreement study.","authors":"Tram T N Truong, Van-Anh N Huynh, Kien G To","doi":"10.1371/journal.pgph.0004725","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004725","url":null,"abstract":"<p><p>To compare the level of physical activity (PA) measured by self-reported questionnaire and pedometer in 12-year-old Vietnamese adolescents. Data was collected from March to May 2023 in two phases among 510 sixth-grade students in Ho Chi Minh City, Vietnam. The first phase involved a pilot study, which recruited 35 students from a randomly selected class to evaluate the Physical Activity Questionnaire for Older Children (PAQ-C) test-retest reliability. PA was measured twice, with seven-day intervals between assessments. The second phase was a cross-sectional study including 475 sixth-grade students to evaluate the agreement between PAQ-C scores and pedometer data. Participants wore a pedometer continuously for seven days and completed the PAQ-C at the end of the monitoring period. Sociodemographic and anthropometric data were collected. The sample of 35 students showed that PAQ-C demonstrated good internal consistency (α = 0.89) and test-retest reliability (ICC = 0.82). After one week, McNemar's test indicated no significant difference in activity levels between the baseline and second assessment. In the sample of 475 students, there was a substantial agreement between PAQ-C and pedometer in classifying physical activity levels (Cohen's κ = 0.688, p < 0.001), with a strong correlation between daily step counts and PAQ-C scores (rs = 0.855, p < 0.001). PAQ-C is a reliable, cost-effective tool for school-based PA monitoring in 12-year-old Vietnamese adolescents, particularly in resource-limited settings.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0004725"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251218","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":"Evolution of the nutritional status and factors associated with undernutrition in children under five of age between 2014 and 2017 in 24 health districts of Burkina Faso.","authors":"T Bernadette Picbougoum, M A Serge Somda, Isidore T Traoré, Julia Lohmann, Manuela De Allegri, Hervé Hien, Nicolas Méda, Annie Robert","doi":"10.1371/journal.pgph.0004645","DOIUrl":"10.1371/journal.pgph.0004645","url":null,"abstract":"<p><p>The prevalences of undernutrition in children under five years of age appeared to decrease over the last decade in Burkina Faso. However, the country is now facing new health and security challenges that could threaten this progress. Therefore, it is essential to monitor the evolution of the situation within this specific context. We aimed to assess trends in undernutrition among children under 5 years of age, as well as the factors associated with it, between 2014 and 2017 in Burkina Faso. A study based on secondary analysis of the data from 2013 and 2017 surveys, conducted in 24 districts across six health regions, was carried out. We worked with the household databases to select two sub-samples: 9,259 children from 2014 and 12,119 children from 2017. We assessed anthropometric indicators using World Health Organization standards, analyzed their proportions between 2017 and 2014, and according to the health regions and children's age groups. We examined the association of stunting and underweight with children, mothers, and households' characteristics in 2017 and for two selected health regions, using logistic regression. From 2014 to 2017, the proportion of severe stunting and severe underweight decreased respectively from 24.8% to 7.9% (p < 0.001) and from 19.6% to 8.8% (p < 0.001) certainly due to nutrition and health initiatives. As in 2014, stunting was associated with sex, living in poorest household with AdjOR = 1.31 (95%CI: 1.14 -1.50), or in household having three and more children under five years with AdjOR = 1.28 (95%CI: 1.12 -1.47). This study demonstrated a period of significant progress in undernutrition in children. But it identified the persistence of associated factors contributing to the high prevalence of undernutrition in Burkina Faso, where insecurity has become a prevailing issue. Further studies are needed to assess the sustainability of encouraging progress in children's nutritional status.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0004645"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236178","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":"Length of hospital stay and its associated factors among women who gave birth by cesarean section in general hospitals of Sidama region, Ethiopia.","authors":"Amelo Bolka, Zerihun Weldekidan","doi":"10.1371/journal.pgph.0004582","DOIUrl":"10.1371/journal.pgph.0004582","url":null,"abstract":"<p><p>Despite rising cesarean section (CS) rates in Ethiopia, evidence on determinants of postoperative length of hospital stay (LoS) remains scarce, particularly for rural general hospitals handling most deliveries. This study was aimed at assessing the length of hospital stay and its associated factors among women who undergo cesarean section in general hospitals of the Sidama region. An institution-based cross-sectional study was conducted among 505 post-CS mothers from 1 January to 20 February 2024. A multistage sampling method was followed to select the study respondents. Data was collected using a structured and pretested, interviewer-administered questionnaire. Data was collected using the Kobo Toolbox system and exported to Stata version 14.0 for management and analysis. Factors associated with the length of hospital stay were determined using a Poisson regression model. The factors associated with the outcome variable were identified using the adjusted risk ratio (ARR). Statistical significance was set at a p-value of less than 0.05. The median LoS post-CS was 4 days (interquartile range: 3-4). Significant predictors of prolonged LoS included maternal age (ARR = 1.014, 95% CI: 1.004-1.024), neonatal intensive care unit (NICU) admission (ARR = 1.31, 95% CI: 1.16-1.46), surgical site infection (ARR = 2.39, 95% CI: 1.88-3.04), and low postoperative hemoglobin (ARR = 0.94, 95% CI: 0.92-0.97). The median hospital stay after cesarean delivery in general hospitals of Sidama region was 4 days. Prolonged stays were associated with maternal age, NICU admission, surgical site infection, and low post-op hemoglobin. Targeting high-risk mothers with enhanced monitoring and wound care-alongside NICU-maternity service integration and safety-conscious discharge protocols-is recommended to accelerate recovery.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0004582"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236179","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":"Magnitude of ectopic pregnancy, management methods, and its associated factors among pregnant women attending Ambo University Referral Hospital in Oromia Regional State, Ethiopia: A seven years retrospective institutional based cross-sectional study.","authors":"Nigussie Tesfaye Gizaw, Mekbeb Afework K/Mariam, Motuma Gutu Fayera","doi":"10.1371/journal.pgph.0004611","DOIUrl":"10.1371/journal.pgph.0004611","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Ectopic pregnancy is the implantation of a blastocyst outside of the endometrial lining of the uterus. Ectopic pregnancy can take several forms, including ovarian, abdominal, and tubal. The most prevalent place for ectopic pregnancy is the fallopian tube, which accounts for over 97.7% of all ectopic gestations. The ampulla accounts for around 80% of tubal pregnancy, followed by the isthmus (12%), fimbria (5%). Ectopic pregnancy is diagnosed with the classic triad of amenorrhea, abdominal pain, vaginal bleeding, and a positive pregnancy test.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to assess the magnitude of ectopic pregnancy, its management outcome, and associated factors among pregnant women attending Ambo University Referral Hospital in the Oromia Region, Ethiopia, in 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A seven-year retrospective cross-sectional study, from February 2018 to April 2024, was conducted at the Ambo University Referral Hospital, which is located in Ambo town, Ethiopia. Data concerning all pregnant mothers who were admitted and managed for ectopic pregnancy were extracted from the medical records of patients and the operation book by a trained data collector through Kobo Toolbox electronic data collection software. The collected data was checked first for its completeness, and it was exported into SPSS version 26 software for data analysis. Then Descriptive statistics were employed for summarizing the data, and bivariate and multivariate logistic regression analyses were used to identify the independent effect of the predictor variable on the outcome variable.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;From February 2018 to April 2024, there were 17,687 total pregnancies, 6,249 gynecologic admissions, and 182 cases of ectopic pregnancies at Ambo University Referral Hospital. A total of 173 patients with ectopic pregnancy were included in the data analysis. The magnitude of ectopic pregnancy was 0.98% among the total pregnancies and accounted for 2.77% of all gynecological admissions during the study period. Most of the patients, 81 (46.8%), were in the 25-29 years age group, with a mean age of 27.16 ± SD 4.77 years. Mothers who had a previous history of abortion, a history of pelvic inflammatory disease, a history of ectopic pregnancy, or a history of tubal surgery had a statistically significant association with ectopic pregnancy. The majority of the patients were married, 98 (56.6%), and urban residents, 121 (69.9%). The majority of ectopic pregnancies occurred on the right side of the fallopian tube 144 (83.24%). Among the majority of ectopic pregnancies, 159 (61.3%) were tubal ampullary ectopic pregnancies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion and recommendation: &lt;/strong&gt;The major risk factors identified in this study were previous abortion, pelvic inflammatory disease, a previous history of ectopic pregnancy, and previous tubal surgery. The magnitude of the ectopic pregnancy in this study was 0.98%, which ","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0004611"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236180","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 and health system delays in the diagnosis and treatment of tuberculosis in Gandaki, Nepal.","authors":"Bikram Singh Dhami, Damaru Prasad Paneru, Sagar Parajuli, K C Aarati, Dhirendra Nath","doi":"10.1371/journal.pgph.0004676","DOIUrl":"10.1371/journal.pgph.0004676","url":null,"abstract":"<p><p>Delays in accessing healthcare worsen disease outcomes, increasing Tuberculosis (TB) transmission rates and mortality. Prolonged delays may contribute to drug-resistant TB strains in some cases, this study assessed delays in diagnosis and treatment among TB patients in Gandaki, Nepal. A cross-sectional study was conducted among a randomly selected sample of 194 TB patients enrolled in Direct Observed Treatment Short-course (DOTS) therapy. The data were collected through face-to-face interviews using a semi-structured interview schedule, which was developed through literature review and adaptation of the World Health Organization's multi-country study. Multivariate logistic regression was employed to identify factors associated with delays in diagnosis and treatment, considering a p value < 0.05 to indicate statistical significance. The median patient and health system delays were 35 (7-120) and 9 (2-98) days, respectively. Furthermore, 55.7% and 58.2% of patients experienced patient and health system delays, respectively. In the multivariable logistic regression analysis, factors associated with unacceptable patient delay included non enrollment in government health insurance programmes (AOR: 3.19; 95% CI: 1.29-7.98), seeking care from non-National Tuberculosis Program (non-NTP) providers (AOR: 3.19; 95% CI: 1.460-6.97), poor knowledge of TB (AOR: 3.74; 95% CI: 1.67-8.37), and high levels of perceived stigma (AOR: 3.15; 95% CI: 1.42-6.94). Furthermore, undergoing an initial diagnostic test other than GeneXpert (AOR: 3.25; 95% CI: 1.19-8.87) and visiting healthcare facilities multiple times before being diagnosed with TB (AOR: 5.62; 95% CI: 2.26-13.96) were significantly associated with unacceptable health system delay. Patient and health system delays were prevalent among TB patients. Reducing these delays is crucial for improving TB control. Therefore, urgent action is needed to implement education campaigns to improve TB literacy. Additionally, engaging private and informal healthcare providers and enhancing their capacity to deliver timely and effective TB care could potentially mitigate delays in diagnosis and treatment.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0004676"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236181","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}