PLOS global public health最新文献

{"title":"A qualitative study to explore women's perceptions of pregnancy and antenatal care in Chizenga village, Chikwawa, Malawi.","authors":"Helen Layton, Deborah Nyirenda, Terry Kana","doi":"10.1371/journal.pgph.0005515","DOIUrl":"https://doi.org/10.1371/journal.pgph.0005515","url":null,"abstract":"<p><p>National survey data indicate that only around one quarter of women in Malawi attend their first antenatal care (ANC) visit during the first trimester. This study explores women's perceptions of ANC in Chizenga village, Chikwawa, a rural setting with high maternal mortality and low ANC uptake. Using an interpretivist qualitative design, 14 pregnant women aged 18-44 years were recruited through purposive sampling. Semi-structured interviews were conducted in Chichewa, translated into English, and analysed using thematic analysis to identify patterns across the dataset and develop themes grounded in participants' accounts. Findings indicate that while women valued ANC and recognised its role in reducing maternal and neonatal mortality, most initiated care after the first trimester. Key themes included understanding of pregnancy health and ANC, nutritional constraints despite awareness, gendered dynamics in ANC attendance, the perceived influence of witchcraft, experiences of respectful and disrespectful care, and structural barriers related to distance and transport. Socioeconomic constraints, particularly distance, transport costs, and limited health literacy, contributed to delayed ANC attendance. Nevertheless, women demonstrated resilience and a strong commitment to maternal health, with some walking over 22 kilometres to access services. Participants voiced a need for increased ANC education and proposed community-based solutions such as health worker outreach and improved access to services. The study calls for context-sensitive policy interventions, including community-based health education, outreach antenatal services, and improved transport support, to ensure equitable access to respectful antenatal care.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 9","pages":"e0005515"},"PeriodicalIF":2.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066626","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":"Incidence and risk factors of hyperglycemic emergencies in adults with diabetes in the public hospitals in Harari region, Eastern Ethiopia.","authors":"Birhanu Shegene, Abdi Birhanu, Alemayehu Tesfaye, Abera Cheru, Nano Belema, Kasiye Shiferaw","doi":"10.1371/journal.pgph.0007345","DOIUrl":"10.1371/journal.pgph.0007345","url":null,"abstract":"<p><p>Hyperglycemic emergencies are the most common life-threatening acute metabolic complications of diabetes mellitus. The number of hyperglycemic emergency admissions over the past decade has increased worldwide, with recent data reporting a 55% increase in the rate of diabetic ketoacidosis hospitalizations. Therefore, this study aimed to determine the incidence and predictors of hyperglycemic emergencies among adult diabetic patients at public hospitals in the Harari Region, Eastern Ethiopia. A retrospective cohort study was conducted among 496 adults with diabetes. Data were collected using the Kobo toolbox and analyzed using STATA. The Kaplan-Meier curve and log-rank test were used to estimate the survival probability and statistically test survival between different categories, respectively. Predictors of hyperglycemic emergencies were determined using the Cox proportional hazard regression model. Hazard ratios (HR) with their respective 95% confidence interval (CI) and p-value were computed. Of the 472 patients included in the study, 34.11% (95% CI: 29.96%-38.52%) developed hyperglycemic emergencies. The incidence rate of hyperglycemic emergencies was 18.6 per 100 person-years observation (95%CI: 15.9-21.7). The median hyperglycemic emergency-free survival time was 51.06 months (95% CI: 45.14-58.56). Being a rural area residents (Adjusted Hazard Ratio(AHR): 1.52, 95% CI: 1.07,2.16), not having community health insurance (AHR: 1.63, 95% CI: 1.14-2.34), experiencing acute recent illness (AHR: 2.15, 95% CI: 1.51,3.07), having type 1 diabetes mellitus (AHR: 1.97, 95% CI: 1.23,3.15), having poorly controlled blood glucose (AHR: 3.06, 95% CI: 2.01,4.66), non-adherence with diabetes medication (AHR: 2.25, 95% CI: 1.55,3.26), being obese (AHR: 3.75, 95% CI: 1.84,7.64) and overweight (AHR: 2.56, 95% CI: 1.72,3.81) were factors significantly associated with hyperglycemic emergencies. The findings demonstrated that the incidence of hyperglycemic emergencies was high. Hence, special emphasis should be placed on follow-up care for diabetic patients with identified predictors to reduce the occurrence of these emergencies.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 9","pages":"e0007345"},"PeriodicalIF":2.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066745","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":"Decolonising global health evaluations: A scoping review of methodological frameworks.","authors":"Sali Hafez, Agata Pacho, Seyi Soremekun, Meghna Ranganathan, Mitzy Gafos, Lucy Platt, Ruth Ponsford","doi":"10.1371/journal.pgph.0007362","DOIUrl":"10.1371/journal.pgph.0007362","url":null,"abstract":"<p><p>The field of global health evaluation is critiqued for its reliance on Eurocentric paradigms that perpetuate epistemic injustice. A rapidly evolving yet conceptually fragmented literature on decolonising evaluation has emerged in response. We conducted a scoping review to chart the nature and breadth of this literature and synthesise insights to guide future evaluation scholarship and practice. Academic database searches identified 1,024 records, of which 732 were screened at title and abstract following deduplication. Combined with 138 records from grey literature and citation searches, a total of 653 reports were assessed at full text, from which 59 records were included in the final synthesis. Our synthesis reveals that the literature points in two concurrent, dialectical and complementary theoretical projects: the first involving the deconstruction of colonial systems, and the second the (re)construction of decolonial and Indigenous-centred alternatives. We organised our findings into a typology that illustrates a spectrum of praxis in global public health evaluation, which moves from minimal adaptation of dominant methodological approaches to a more profound philosophical and political reorientation of practice. This paper calls for greater conceptual precision in the description of chosen approaches to prevent the co-optation of decolonial language and the need for empirical research to bridge the gap between theory and practice.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 9","pages":"e0007362"},"PeriodicalIF":2.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066675","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":"Feasibility and performance of eye movement perimetry for glaucoma triage in Tanzania: A prospective cross-sectional study in a real-world setting.","authors":"Arun J Thirunavukarasu, Victor H Hu, Pete R Jones, Elliott H Taylor, Einoti Matayan, Sia Mbishi, Edith Macha, Tara Mtuy, David P Crabb, William Makupa, Matthew J Burton, Heiko Philippin","doi":"10.1371/journal.pgph.0007237","DOIUrl":"10.1371/journal.pgph.0007237","url":null,"abstract":"<p><p>Triaging access to glaucoma diagnostics could allow patients to receive earlier care to slow disease progression. There is a particular need in lower-resource settings where the cost and lack of portability of standard automated perimetry (SAP) restrict access. Eye movement perimetry (EMP) uses eye-tracking technology to provide a rapid assessment of the visual field using a tablet computer. A cross-sectional study in Tanzania was undertaken to assess the feasibility of EMP as an initial glaucoma triage tool. EMP hit rate correlated with SAP mean deviation in 370 eyes (Spearman's rank correlation coefficient, ρ = 0.441, p < 0.001) and graphical comparisons indicated good localisation of defects. In emulated triage of 232 participants, EMP exhibited very high (100.0%) sensitivity (95%CI: 95.5 to 100.0%) in identifying eyes with mean deviation ≤ -6 dB), meaning that a high EMP hit rate was strong evidence of a healthy visual field. However, specificity was 20.7% (95%CI: 15.0 to 27.8%), meaning that many individuals with no severe field defect would require SAP to confirm this. Specificity was limited by EMP test failure, which occurred in 75 of 480 eyes (15.6%), as well as export or processing failure which occurred in 35 eyes (7.3%). Participants preferred EMP to SAP testing and agreed that it was easy to perform. In a real-world setting, EMP rapidly and accurately identifies patients without a significant visual field defect. However, refinement is required to reduce the high number of unnecessary referrals or false positives for EMP to prove useful as a triage tool.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 9","pages":"e0007237"},"PeriodicalIF":2.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066708","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":"Community risk perceptions and recommendations for drowning prevention: A qualitative study across West Bengal, India.","authors":"Debayanti Bhowmick, Soumyadeep Bhaumik, Jagnoor Jagnoor","doi":"10.1371/journal.pgph.0007377","DOIUrl":"10.1371/journal.pgph.0007377","url":null,"abstract":"<p><p>Drowning is a leading cause of injury-related mortality worldwide, with disproportionate impacts on low- and middle-income countries. West Bengal, India, is characterized by extensive exposure to natural water bodies and marked regional and urban-rural heterogeneity. There is limited research on community risk perceptions and contextual drivers of drowning in this area, which constrains the design of effective prevention strategies. This qualitative study applied a phenomenological approach and conducted 46 focus group discussions involving a total of 339 participants from urban and rural communities across all 23 districts of West Bengal. Districts were selected based on recent drowning incidents. Adult residents were purposively sampled with support from local humanitarian organization. Data collection combined semi-structured interviews in local language, audio recording, and thematic analysis, iteratively coded to saturation using NVivo software. Four major themes emerged: (1) infrastructure and risk varies between urban and rural regions for instance differences in use and type of water sources, healthcare access and community connectedness; (2) Community awareness of population vulnerability, environmental risks, and other contextual exposures to drowning were identified where children, elderly, domestic migrant workers and non-swimmers were found to be vulnerable; (3) Adaptive response to threat through prevention, accessibility and rescue methods included informal rescue, reliance on traditional beliefs and expressions of fatalism; (4) Community recommendations based on lived experiences and risk perception of drowning were focused on fencing water bodies, enhancing childcare programs, strengthening medical infrastructure and providing swimming instruction. Infrastructure gaps and climate variability further heighten drowning risks in particularly exposed regions and households. Community risk perceptions underscore urgent priorities for drowning prevention in West Bengal. While findings are consistent across districts, intervention priorities vary according to regional needs.Strategies should strengthen supervision, physical barriers, childcare, water safety education, and access to critical care, informed by local perceptions and practices.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 9","pages":"e0007377"},"PeriodicalIF":2.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13606942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042577","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":"High prevalence and multidrug resistance of Methicillin-resistant Staphylococcus aureus at a provincial referral hospital in Zambia: A 5-year retrospective study.","authors":"Mavis S Nyakayoya, Dennis Chisala, Kennedy Lubundi, Hariet Milambo, Masiliso A Liamba, Kesaobaka Batisani, David Chisompola","doi":"10.1371/journal.pgph.0007348","DOIUrl":"10.1371/journal.pgph.0007348","url":null,"abstract":"<p><p>Methicillin-resistant Staphylococcus aureus (MRSA) poses challenges in healthcare settings, contributing to antimicrobial resistance and complicating treatment of staphylococcal infections. In resource-limited settings such as Zambia, staphylococcal infections are treated empirically with clindamycin or co-trimoxazole due to limited susceptibility testing. However, MRSA and multidrug resistance are reducing treatment effectiveness. This study aimed to determine the prevalence and antimicrobial susceptibility of MRSA at Mansa General Hospital, Zambia. A retrospective cross-sectional study was conducted on 266 clinical S. aureus isolates from 2020-2024. Bacterial identification was performed using microbiological methods (Mannitol Salt Agar, catalase, coagulase, DNase tests). MRSA detection and antimicrobial susceptibility testing (AST) using the Kirby-Bauer disk diffusion- method with cefoxitin (30 µg) as a surrogate marker, interpreted according to CLSI M100 34th Edition guidelines. Multivariable logistic regression identified factors associated with MRSA. Among 266 S. aureus isolates, the overall MRSA prevalence was 31.6% (84/266). MRSA demonstrated significantly lower susceptibility than MSSA to non-beta-lactam antibiotics: clindamycin (46.2% vs. 67.7%), erythromycin (50.0% vs. 79.5%), ciprofloxacin (58.2% vs. 91.4%), and tetracycline (58.3% vs. 81.9%). Chloramphenicol (86.5% vs. 100%) and linezolid (81.8% vs. 97.9%) retained activity. MDR prevalence was 28.6% (76/266), with higher MDR (57.1%, 48/84) than MSSA (15.4%, 28/182). Older age was independently associated with MRSA: adults aged 45-59 years (AOR 2.77; 95% CI 1.09-7.01; p = 0.032) and ≥60 years (AOR 4.53; 95% CI 1.45-14.1; p = 0.009) had higher odds compared to children. Sex, patient type and specimen source were not significant predictors. This study highlights the high prevalence of MRSA at Mansa General Hospital, reduced susceptibility to used oral antibiotics and a burden of multidrug resistance. Empirical use of clindamycin and erythromycin for suspected staphylococcal skin and soft tissue infections should be reconsidered and guided by local antimicrobial susceptibility whenever available. Continued local surveillance and multicenter studies are needed to inform empirical treatment guidelines across Zambia.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 9","pages":"e0007348"},"PeriodicalIF":2.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13606941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042571","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":"Postpartum integration of infant vaccines and contraception through gender transformative programming: A cluster randomized trial in India.","authors":"Sarah Averbach, Mohan Ghule, Gennifer Kully, Nicole E Johns, Madhusudan Battala, Vedavati Patwardhan, Anita Raj, Shahina Begum","doi":"10.1371/journal.pgph.0006403","DOIUrl":"10.1371/journal.pgph.0006403","url":null,"abstract":"<p><p>Barriers to using contraception in India include norms that promote gender inequality by restricting mobility of women to reach health clinics. We evaluated whether PIVoT (Postpartum Integration of Vaccines and contraception through gender-Transformative programming) improves contraceptive use while enhancing autonomy in contraceptive decision-making. PIVoT delivers the full spectrum of contraceptive methods available along with gender-transformative counseling, linked with community-based infant vaccination. We conducted a cluster randomized trial; 20 Anganwadi Community centers were randomized to PIVoT or the standard-of-care. We included women 18 years and older, within 12 weeks postpartum, presenting for infant vaccination at community centers in rural Maharashtra, India. We measured contraceptive use (primary outcome) and reproductive autonomy after six months. From September 2023 to June 2024, we enrolled 293 women: 143 at intervention and 150 at control sites. Follow-up at six months was 95%. Any contraceptive use was more common for the control group at baseline (n = 57, 39.9% vs n = 93, 62.0%, p < 0.001) and for the intervention group at follow-up (n = 67, 48.9% vs n = 53, 37.3%, p = 0.051). There was a time-by-treatment effect for any contraceptive use (adjusted ratio of odds ratios 3.98, 95% CI 1.95-8.12). IUD use was slightly higher at six months in the intervention group (2.9% vs 0%, p = 0.04). Use of female-controlled methods (permanent contraception, pills, IUDs, injectables) was higher at six months among the intervention group (13.1% vs 6.3%, p = 0.04). Reproductive decision-making autonomy was higher among intervention participants at follow-up (2.02 vs 1.93, p = 0.02). The PIVoT intervention may increase contraceptive use postpartum, particularly female-controlled methods, while improving reproductive autonomy.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 9","pages":"e0006403"},"PeriodicalIF":2.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13606928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042551","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":"Supply, demand and use of economic evidence in vaccine policymaking in Africa: A scoping review.","authors":"Esther Mazuba, Joseph Kazibwe, Joseph Chirwa, Alick Banda, Oliver Kaonga, Bona Chitah, Stacey Orangi, Edwine Barasa, Felix Masiye","doi":"10.1371/journal.pgph.0007080","DOIUrl":"10.1371/journal.pgph.0007080","url":null,"abstract":"<p><p>Economic evaluation offers policy makers a valuable tool for optimizing the use scarce healthcare resources. This scoping review aims to describe the existing scientific literature on economic evaluation and budget impact analysis of vaccine interventions, and the use of economic evidence in Africa. It highlights the current landscape and the challenges in using economic data to support vaccine policy on the continent. This study adapted and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We included peer-reviewed studies published in English between January 2000 and July 2025 that reported on cost and economic evaluations of vaccines administered to children and youth, or on the use of economic evidence for policy decision-making in Africa. A literature search was conducted across five electronic databases: Medline, Embase, Web of Science, and Scopus. The search yielded 4037 articles in total after deduction of duplication. A total of 140 articles were included in the study following title, abstract screening and full text review. The review identified a sparse but growing literature of economic evaluations related to vaccine interventions in Africa. Only a handful of countries are represented in the articles published, implying a very low production of (and likely a low demand for) economic evaluation evidence. Authorship of the articles is led mostly by researchers from institutions based outside Africa, mostly in North America and Europe. Funding of studies is mostly by Gates Foundation, Gavi, PATH, Wellcome Trust and World Health Organisation. Production and use of economic evaluation for vaccine policy in Africa have been hampered by capacity limitations in both research and policy institutions on the continent. The use of the evidence in decision making is limited. In the sphere of vaccine policy, economic evaluation is still a fledging enterprise requiring more investment.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 9","pages":"e0007080"},"PeriodicalIF":2.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13606984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042621","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":"Metabolic health and cardiovascular risk among Cameroonian adults with and without obesity.","authors":"Maxwell Wandji Nguedjo, Ousmane Mfopou Mbiondi, Kevin Fabrice Paul Mandeng, Alex Dimitri Tchuenchieu Kamgain, Gabriel Nama Medoua, Judith Laure Ngondi, Julius Enyong Oben","doi":"10.1371/journal.pgph.0006870","DOIUrl":"10.1371/journal.pgph.0006870","url":null,"abstract":"<p><p>Obesity contributes to increased morbidity and mortality, yet its metabolic heterogeneity remains underexplored in sub-Saharan Africa. This study examined associations between body composition, insulin sensitivity, inflammation, and the metabolically healthy profile (MHP), and assessed cardiovascular risk among Cameroonian adults with and without obesity. In this cross-sectional study, 490 participants from the West region of Cameroon underwent anthropometric and metabolic assessments. Ten-year cardiovascular risk was estimated using the Framingham risk score. Logistic regression identified predictors of MHP and determinants of elevated cardiovascular risk. The prevalence of MHP was 59.6% among individuals with normal weight, 11.5% among those with overweight, and 38.2% among those with obesity. Participants with overweight, obesity, android obesity or insulin resistance were 92%, 59%, 58%, and 46% less likely to have a MHP than participants in the control groups, respectively. Inflammation defined solely by CRP-hs was not predictive. Compared with metabolically unhealthy counterparts, metabolically healthy obese (OR = 6.27; 95% CI: 3.15-12.48) and overweight (OR = 2.50; 95% CI: 0.72-8.65) individuals had substantially lower predicted 10-year cardiovascular risk. Metabolic phenotyping reveals that not all Cameroonians with overweight and obesity present the same cardiovascular risk. Incorporating fat distribution and insulin sensitivity into clinical evaluation could improve early identification of high-risk individuals and guide tailored prevention strategies.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 9","pages":"e0006870"},"PeriodicalIF":2.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032333","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":"Evaluation of surveillance performance and determinants for priority vaccine-preventable diseases in Niger State, Nigeria: A CDC 2001 Guideline-based multilevel analysis.","authors":"Oladayo David Awoyale, Akolade Jimoh, Anne Dede, Rauf Ibrahim Rauf, Arab Mustafa, Tosin Ayokunmi Sowade, Patrick B Gimba, Idris Ibrahim, Catherine Nabiem Akpen, Eugene Chidi Eugene, Grace Fubara Erekosima, Chibuike Okekeigwe, Moses Job Tarfa, Saheed D Isiaka, Hilary Okagbue, Sunday Atobatele, Sidney Sampson","doi":"10.1371/journal.pgph.0005928","DOIUrl":"10.1371/journal.pgph.0005928","url":null,"abstract":"<p><p>Vaccine-preventable diseases (VPDs) remain important causes of morbidity and mortality in sub-Saharan Africa, and evidence on subnational surveillance performance in Nigeria remains limited. We conducted a cross-sectional analytic evaluation of surveillance systems for measles, diphtheria, acute flaccid paralysis (AFP), and cerebrospinal meningitis (CSM) in Niger State, Nigeria. Data were collected from 415 clinicians, community resource persons, and surveillance focal persons across 12 purposively selected Local Government Areas using structured questionnaires adapted from CDC surveillance evaluation guidelines and aligned with IDSR guidance. Surveillance performance was assessed using sensitivity, data quality, and stability. Analyses included descriptive statistics, bivariate tests, and multivariable regression models. Reported suspected case detection was higher for measles and AFP than for CSM and diphtheria, with detection reported by 94.2% and 93.0% of respondents for measles and AFP, respectively, compared with 84.3% for CSM and 81.4% for diphtheria. Transport availability without delays was consistently associated with lower odds of surveillance failure across disease-specific models, including measles sample collection (aOR = 0.12, 95% CI: 0.05-0.28) and case confirmation (aOR = 0.07, 95% CI: 0.02-0.21), diphtheria sample collection (aOR = 0.18, 95% CI: 0.06-0.49) and confirmation (aOR = 0.22, 95% CI: 0.08-0.58), and CSM sample collection (aOR = 0.18, 95% CI: 0.06-0.54) and confirmation (aOR = 0.21, 95% CI: 0.07-0.61). Active guideline use was associated with AFP sample collection (aOR = 4.12, 95% CI: 1.72-9.87). Only 66.5% of respondents reported fully accurate submitted forms, and financial support was associated with lower odds of instability (aOR = 0.74, 95% CI: 0.56-0.97). Strengthening transport, infrastructure, financing, and data quality systems may improve VPD surveillance performance and outbreak preparedness in similar settings.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"6 9","pages":"e0005928"},"PeriodicalIF":2.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032316","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}