PLOS global public health最新文献

{"title":"The impact and cost of reaching the UNAIDS global HIV targets.","authors":"John Stover, Deepak Mattur, Mariana Siapka, Triantafyllos Pliakas, Ricardo Valladares-Cardona","doi":"10.1371/journal.pgph.0007360","DOIUrl":"10.1371/journal.pgph.0007360","url":null,"abstract":"<p><p>HIV funding has been declining in the past decade creating a large gap in required funding. In 2024, UNAIDS (Joint United Nations Programme on HIV/AIDS) convened a Global Task Team in 2024 to recommend new targets and approaches for 2030 for key HIV interventions. This paper describes the approach to estimate the impact and cost of achieving those targets. We calibrated an HIV simulation model, Goals, to the historical HIV epidemic in 134 countries and used the model to project the impact of achieving the UNAIDS targets by 2030. Resource needs were estimated for 118 low-, lower-middle and upper-middle income countries (LMIC). To estimate the cost of achieving the targets we compiled a database of the unit costs for each intervention from published studies, country reports and commodity costs. Achieving the UNAIDS 2030 targets would reduce the annual number of new HIV infections globally by 77% from 2023 to 2030, from 1.3 million to 300,000. The number of AIDS deaths would decline by 50% over the same period. Resources needed to achieve the targets in all LMIC would rise to US$21.9 billion by 2030. Of this amount, 17% is needed in low-income countries, 38% in lower-middle income countries and 45% in upper-middle income countries. Achieving the UNAIDS targets for 2030 would reduce the annual number of new HIV infections to just 9% of the peak value in 1995 and AIDS deaths to 13% of the peak value in 2004. The resources required to achieve these targets are substantial but $7 billion less than previous estimates of $29.3 billion.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 10","pages":"e0007360"},"PeriodicalIF":2.8,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229234","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":"Assessing a local vaccination initiative: Eight years of \"Immuniser Lyon\" in France.","authors":"Juliette Dessemon, Romain Saux, Christelle Elias, Anne-Sophie Ronnaux-Baron, Anne Sophie Malachane, Sophie Pamies-Jeantet, Benoit Soubeyrand, Pascal Roy, Philippe Vanhems","doi":"10.1371/journal.pgph.0007468","DOIUrl":"10.1371/journal.pgph.0007468","url":null,"abstract":"<p><p>\"Immuniser Lyon\" (IL) is a French city-level initiative launched in 2015 to promote vaccination through coordinated, locally tailored actions. The objective of this study is to describe and compare temporal trends in vaccine coverage for HPV and influenza in the Rhône area versus the neighboring Auvergne-Rhône-Alpes (ARA) region, and to explore whether observed patterns are consistent with a potential contribution of the IL initiative. A comparative analysis of vaccine coverage was performed for HPV (2010-2022) and influenza (2016-2020) between different areas within the Auvergne-Rhône-Alpes (ARA) region versus the ARA region, using binomial log-linear models. HPV vaccine coverage in Rhône and ARA followed similar patterns, increasing from 2015 to 2022 after a nationwide decline. For influenza, vaccine coverage among adults aged ≥65 was significantly higher in Lyon in 2020 (64.5%) than in the rest of ARA (59.2%, OR=1.25, 95% CI [1.24-1.26], p < 0.001). While HPV trends reflected broader national dynamics, the observed pattern may be consistent with a potential contribution of IL to the accelerated uptake of influenza vaccines in older adults. These findings highlight the potential of sustained local action to complement national immunization strategies.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 10","pages":"e0007468"},"PeriodicalIF":2.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208345","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":"Correction: Quality of life, stress and its coping strategies among the parents of children with autism spectrum disorder in Kathmandu Valley: A mixed method study.","authors":"Sajani Basan, Amit Arjyal, Shital Bhandary","doi":"10.1371/journal.pgph.0007504","DOIUrl":"10.1371/journal.pgph.0007504","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1371/journal.pgph.0006997.].</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 10","pages":"e0007504"},"PeriodicalIF":2.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208360","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":"Mental health and psychosocial wellbeing among beneficiaries of a community-based intervention in Nepal: Findings from a cross-sectional endline evaluation of the PARBARDHAN project.","authors":"Himal Gaire, Ganesh Bhandari, Rima Mishra, Ram Lal Shrestha, Aishwarya Prasad Dhakal, Pashupati Mahat","doi":"10.1371/journal.pgph.0006666","DOIUrl":"10.1371/journal.pgph.0006666","url":null,"abstract":"<p><p>Mental health and psychosocial wellbeing among migrant workers and their families are important public health concerns in Nepal. The PARBARDHAN project used a community-based approach to strengthen mental health and psychosocial support, community participation, and local service capacity in migration-affected communities. This study describes psychosocial wellbeing at endline evaluation and compares findings descriptively with baseline and midline. A cross-sectional, mixed-methods endline evaluation was conducted in Salyan and Kailali districts of Nepal. The quantitative component included 245 project beneficiaries aged 16-80 yearsincluding20 (8.2%) migrant/returnee workers and 225 (91.8%) family/community respondents; 216 (88.2%) reported having a family member currently abroad. Psychological distress was assessed using the General Health Questionnaire (GHQ-12), and anxiety and depression the Hopkins Symptom Checklist (HSCL-25). Life satisfaction and subjective happiness were assessed. Qualitative interviews and focus group discussions provided contextual information on project implementation and perceived effects. Quantitative data were analysed using descriptive statistics while qualitative data were analysed using framework analysis. Data were collected from3-26 February, 2026. At endline, 34.7% screened positive for psychological distress, while 8.2% screened positive for anxiety and 5.3% for depression (5.3%). Compared with baseline and midline assessment rounds, anxiety and depression screening positivity was lower at endline, whereas probable psychological distress was higher. Qualitative findings indicated increased mental health awareness, greater willingness to seek support, perceived reductions in stigma, and support through self-help groups, peer groups counselling, and community activities. However, substantial dissatisfaction with life was also reported. Because the evaluation rounds used independent cross-sectional samples, the observed differences cannot be interpreted as within-person changes or attributed causally to the PARBARDHAN intervention. The findings indicate the perceived value of community-based mental health and psychosocial support while highlighting continuing economic insecurity, family separation, and other structural factors affecting psychosocial wellbeing.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 10","pages":"e0006666"},"PeriodicalIF":2.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208280","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":"Entomological investigations into yellow fever outbreak in northern Ghana.","authors":"Joseph Harold Nyarko Osei, Sellase Pi-Bansa, Kwadwo Kyereme Frempong, Mavis Ofei, Helena Anokyewaa Boakye, Jane Ansah-Owusu, Sandra-Candys Adwirba Akorful, Richard Odoi-Teye Malm, Christopher Nii Laryea Tawiah-Mensah, Mufeez Abudu, Andy Asafu-Adjaye, Seth Offei Addo, Bright Agbodzi, Ronald Bentil, Deborah Pratt, Shirley Nimo-Paintsil, Joseph Humphrey Kofi Bonney, Maxwell Alexander Appawu, Millie-Cindy Aba Aude Koffi, Sylvester Coleman, Millicent Captain-Esoah, Chrysantus Kubio, Daniel Adjei Boakye, Samuel Kweku Dadzie","doi":"10.1371/journal.pgph.0007346","DOIUrl":"10.1371/journal.pgph.0007346","url":null,"abstract":"<p><p>Arboviruses are pathogens of emerging/re-emerging infectious diseases. Half the world's population is at risk. Recent African epidemics confirmed 19,569 cases with 820 deaths. In Ghana, Savannah Region had yellow fever (YF) outbreak in 2021. Reports revealed 35 deaths, 202 suspected cases (case fatality rate (CFR) = 17%), and 70 confirmed cases (CFR = 50%). This paper presents YF outbreak entomological investigations findings. A team with expertise in YF outbreak response were assembled and tasked to assess, contain and/or control the rapid spread of YF. Immature Aedes aegypti were collected in/around houses, and adult sampled using BG-Sentinel traps, oral aspirators and Prokopack. The chikungunya, dengue fever, YF, and Zika viruses screening using real time reverse-transcription PCR (detection limit <10 RNA copies/reaction) followed mosquitoes morphological identification. Breeding containers (12,264) were examined. Larvae (3,885) and pupae (1,186) were obtained from 173 containers (positivity rate = 1.26%). Larvae were identified with short and stout siphons. Pupae had short but distinct serrated spicules on paddle fringe and branched/fanlike (6-7 branches) seta 9-VIII. Out of 1,001 houses surveyed, 130 were positive for larvae/pupae (positivity rate = 12.99%). Receptacles included plastic [46.95% (6,529)], metallic [43.32% (6,024)], clay jar [5.42% (753)], tire [4.06% (565)], and well [0.24% (34)]. WHO larval indices thresholds (BI, CI, HI, and PDI) were used to assess risk. Exactly 1,571 adults were identified [Aedes aegypti aegypti (35), Aedes aegypti formosus (619), and Culex sp. (917)]. Outdoor collection were higher (86.4%) than indoors (13.6%). No arboviruses were detected. Generally, vector indices/densities suggested high-risk arbovirus transmission although vectors were not arbovirus positive. Aedes aegypti formosus was dominant. They are bridge vectors maintaining sylvatic YF cycles and spillover transmission. High risk for YF poses public health threat that calls for Aedes mosquito surveillance systems and vector control strategies. Ae. ae. formosus might be drivers for outbreak and/or YF transmission.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 10","pages":"e0007346"},"PeriodicalIF":2.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198323","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":"Counted, not just rescued: Nepal's flood, and the test of an 'Always On' health system.","authors":"Krishna Kumar Aryal, Anil Bhattarai, Akina Shrestha, Sirjana Adhikari, Kjell Arne Johansson","doi":"10.1371/journal.pgph.0007486","DOIUrl":"10.1371/journal.pgph.0007486","url":null,"abstract":"","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 10","pages":"e0007486"},"PeriodicalIF":2.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198356","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":"Social determinants of access to reproductive health services among Afghan migrant women in Iran: A qualitative study.","authors":"Seyedeh Tahereh Mirmolaei, Zohreh Mahmoodi, Amirhossein Takian, Zahra Bayat Jozani","doi":"10.1371/journal.pgph.0007406","DOIUrl":"10.1371/journal.pgph.0007406","url":null,"abstract":"<p><p>Migrant women, particularly those from low-resource settings, often face restricted access to reproductive health services in host countries due to intersecting social, economic, and structural barriers. This study explored these barriers among Afghan migrant women in Iran using the World Health Organization's Social Determinants of Health (SDH) model. This qualitative study employed semi-structured, in-depth interviews with 20 purposively sampled Afghan migrant women of reproductive age and 10 key informants from healthcare, midwifery, NGO, and policy backgrounds. Maximum variation sampling was used to ensure diversity in residency status, socioeconomic background, and service experiences. Data collection took place in Tehran from April 2024 over six months and analyzed using directed content analysis guided by the World Health Organization's Social Determinants of Health (SDH) framework. Prolonged member checking and peer debriefing enhanced the credibility and confirmability of the final categorization of structural and intermediary determinants. Three interconnected levels of determinants shape Afghan migrant women's reproductive health access. Structural determinants include a restrictive legal and macroeconomic context, undocumented status, banking and communication barriers, and high out-of-pocket costs, compounded by patriarchal norms that limit women's agency. Intermediary determinants include poor material circumstances, psychosocial stressors, and bio-behavioral responses, with care-seeking delays reflecting legal insecurity. Health system and cross-cutting factors, including the lack of migrant-sensitive facilities, linguistic mismatches, and perceived discrimination, further deter service utilization. Social capital and NGO support provide vital bridges to care, yet the intersection of these determinants creates a vulnerability that perpetuates health inequities and restricts access to essential services. This study clarifies how structural and intermediary determinants interact to shape the barriers Afghan migrant women face in accessing reproductive health services in Iran. These findings can inform targeted, migrant-sensitive policy and programmatic interventions to enhance service equity and lower long-term healthcare costs for both migrant populations and the host country.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 10","pages":"e0007406"},"PeriodicalIF":2.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198278","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":"Improving medical missions: A student and trainee tool for ethical engagement.","authors":"Issa Beatriz Palomata, Joshua D Guzman, Britney Momanyi, Kala M Mehta","doi":"10.1371/journal.pgph.0007415","DOIUrl":"10.1371/journal.pgph.0007415","url":null,"abstract":"","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 10","pages":"e0007415"},"PeriodicalIF":2.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198309","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":"Evaluating the association between household water, sanitation and hygiene (WASH) and selected placenta-related complications in The Gambia, Kenya and Mozambique.","authors":"Joseph Wells, Joseph Waiswa, Anifa Vala, Bahtisen Golla, Grace Mwashigadi, Hawanatu Jah, Marleen Temmerman, Robin Okello, Isaac Mwaniki, Herminio Cossa, Moses Mukhanya, Esperança Sevene, Yahaya Idris, Onesmus Wanje, Angela Koech, Anna Roca, Laura Braun, Marie-Laure Volvert, Fatima Touray, Umberto D'Alessandro, Peter von Dadelszen, Wendy Graham, Hannah Blencowe","doi":"10.1371/journal.pgph.0005004","DOIUrl":"10.1371/journal.pgph.0005004","url":null,"abstract":"<p><p>Placenta-related complications contribute substantially to maternal and perinatal mortality globally, with the greatest burden in low- and middle-income countries (LMICs). However, the potential influence of inadequate household water, sanitation and hygiene (WASH) on these outcomes remains poorly characterised. We investigated associations between household WASH conditions and selected placenta-related complications, including pre-eclampsia, small-for-gestational-age (SGA) and stillbirth, in The Gambia, Kenya and Mozambique. This secondary analysis was nested within PRECISE (PREgnancy Care Integrating Translational Science, Everywhere), a prospective observational cohort of 5,745 unselected pregnant women. Multivariable modified Poisson regression with robust standard errors was used to assess associations between household WASH exposures and pre-eclampsia, SGA or stillbirth. Missing exposure and covariate data were low (<5%) and handled using multiple imputation. Compared with water piped into the dwelling or plot, other improved water sources (adjusted relative risk [aRR] 1.18, 95% confidence interval [CI] 1.07-1.31, p = 0.002) and unimproved water sources (aRR 1.23, 95% CI 1.00-1.50, p = 0.049) were associated with a higher risk of any selected placenta-related complication. Unimproved sanitation facilities, compared with improved facilities, were also associated with increased risk (aRR 1.15, 95% CI 1.02-1.30, p = 0.019). The findings suggest that household‑level WASH conditions may be associated with selected placenta‑related complications through both direct and indirect pathways. Water sources, whether unimproved or improved, may be contaminated, and collection, transport, and storage further increase contamination risks while adding a physical burden to water collectors. Unsafe sanitation may also increase exposure to enteric pathogens. Given the observed associations, targeted WASH interventions warrant investigation as a potential strategy to reduce placenta-related complications and improve maternal and neonatal health outcomes in LMICs. Future research should explore the mechanisms linking WASH to pre-eclampsia, SGA, stillbirth and other placenta-related complications, and assess the effect of comprehensive WASH interventions.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 10","pages":"e0005004"},"PeriodicalIF":2.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198326","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":"Bedside screening of carbapenem-resistant Enterobacteriaceae using selective agar plates: A low-cost, laboratory-independent approach for rural healthcare facilities.","authors":"The Anh Ngo, Hieu Thi Nguyen, Nhung Ngoc Hoang, Thanh Duc Nguyen, Thanh Chi Tran","doi":"10.1371/journal.pgph.0007479","DOIUrl":"10.1371/journal.pgph.0007479","url":null,"abstract":"<p><p>The global surge of carbapenem-resistant Enterobacteriaceae (CRE) poses a critical threat to patient safety in intensive care units (ICUs). In low- and middle-income countries, routine CRE surveillance is often limited by the lack of microbiology laboratory infrastructure and trained personnel in peripheral healthcare facilities, resulting in reliance on empirical broad-spectrum antibiotic therapy and limited capacity to detect silent transmission. This study evaluated the operational feasibility, safety, and phenotypic agreement of a decentralized, laboratory-independent bedside CRE screening protocol using pre-formulated selective chromogenic agar and a low-cost portable incubator. Dual rectal swabs were collected from 220 ICU patients at Viet Tiep Hospital, Vietnam. One sample was processed using standard centralized laboratory procedures as the reference method, while the parallel sample was processed at the bedside by frontline nursing staff, including direct plate inoculation and point-of-care incubation. Diagnostic agreement, inter-reader reliability, procedural contamination, and operational feasibility were assessed. Gastrointestinal CRE carriage was identified in 26 of 220 patients (11.8%), with the KESC group accounting for 76.9% of positive cases. The bedside protocol demonstrated 100% phenotypic concordance with standard laboratory cultures, with 100% sensitivity, specificity, positive predictive value, and negative predictive value. Blinded assessment showed complete inter-reader agreement (κ = 1.0). No environmental cross-contamination was detected on CRE-negative plates (0.0%; 95% CI: 0-4.1%). The decentralized bedside screening model, costing less than US$1 per test, demonstrated high diagnostic agreement and operational feasibility when performed by frontline nursing staff in a non-sterile ICU environment. This approach may provide an affordable alternative for CRE surveillance in resource-limited healthcare facilities where centralized microbiology laboratory infrastructure is unavailable.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 10","pages":"e0007479"},"PeriodicalIF":2.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198261","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}