PLOS global public health最新文献

{"title":"Impact of the Covid-19 pandemic on mental health of persons with disabilities: Insights from the 2021 Canadian Housing Survey.","authors":"Sulemana Ansumah Saaka, Roger Antabe, Isaac Luginaah","doi":"10.1371/journal.pgph.0004728","DOIUrl":"10.1371/journal.pgph.0004728","url":null,"abstract":"<p><p>Mental health (MH) remains a major public health concern in Canada and has been exacerbated by the unprecedented challenges of the COVID-19 pandemic and the associated restrictions on physical movement. While considerable work has been done on the impact of COVID-19 on the physical and MH of the general population, relatively less work has focused on the MH of persons with disabilities (PWDs). Although the COVID-19 containment measures including lockdowns, social distancing, quarantine, and closure of nonessential services were intended to reduce the direct risks of COVID-19, the socioeconomic consequences of those restrictions and the uncertainties surrounding the virus, inadvertently had adverse impact on the MH and well-being of Canadian residents, particularly, among already marginalized groups such as PWDs. Moreover, PWDs were identified as disproportionately vulnerable to the psychological impacts of the pandemic containment measures which compromised their overall Positive Mental Health (PMH): a state of well-being where individuals can realize their full potential, manage life's stresses, work productively, and contribute to society. This study addresses the research gap by examining the effect of the pandemic on the MH of PWDs in Canada using a cross-sectional analysis of the 2021 Canadian Housing Survey (N = 15,626), a subset of people who reported disabilities. Logistic regression models were employed for this cross-sectional analysis. The results show that females (OR = 0.789; P < 0.001), those who experienced COVID-19 economic hardship (OR = 0.703; P < 0.001), and dwelling dissatisfaction (OR = 0.585; P < 0.001), significantly reported about 0.79, 0.70, and 0.59 times lower odds of positive Mental Health (PMH), respectively. On the other hand, those who had post-secondary educational attainment (OR = 1.210; P < 0.001), strong sense of community belonging (OR = 2.056; P < 0.001), and civic engagement with their communities (OR = 1.204; P < 0.001), were significantly associated with 1.21, 2.06, and 1.20 times higher odds of PMH, respectively. Additionally, immigration status, household type, the province of residence, and neighborhood-specific challenges such as race-based harassments, and drug use/dealings emerged as significant predictors of PMH. The findings underscore the positive impacts of empowering elements such as strong community ties on the MH of PWDs during public health crisis. Also, the findings prompt the pressing need for identifying and addressing the unique challenges of PWDs in Canada, particularly, the less educated and socioeconomically disadvantaged, as part of effort to foster PMH in the country. Overall, these findings suggest the need to prioritize and strengthen disability-inclusive MH programs for future public health crises.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0004728"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227864","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":"Harnessing HIV clinics to deliver integrated hypertension care for People living with HIV in Uganda: A formative mixed methods study.","authors":"Fred C Semitala, Florence Ayebare, John Baptist Kiggundu, Christine Kiwala, Joel Senfuma, Gerald N Mutungi, Isaac Ssinabulya, James Kayima, Martin Muddu, Donna Spiegelman, Jeremy I Schwartz, Chris T Longenecker, Anne R Katahoire","doi":"10.1371/journal.pgph.0004701","DOIUrl":"10.1371/journal.pgph.0004701","url":null,"abstract":"<p><p>Access to antiretroviral therapy has led to better treatment outcomes for aging people living with HIV worldwide. However, in Uganda and other parts of sub-Saharan Africa, PLHIV with comorbidities like hypertension experience fragmented healthcare access, despite existing guidelines for the integration of non-communicable diseases into HIV care. We assessed knowledge, attitudes, and practices of PLHIV regarding hypertension care, and their perceptions of integrated hypertension-HIV care. We used a parallel convergent-mixed methods approach to collect quantitative and qualitative data from HIV clinics in urban and peri-urban Uganda. We surveyed PLHIV with hypertension to explore their knowledge, attitudes, and practices related to HTN. We selected a sub-sample from survey participants for qualitative interviews, to explore their perceptions of hypertension care and integrated HTN and HIV services. We analyzed quantitative data using STATA 14.1 and analyzed qualitative data deductively mapping it onto the Consolidated Framework for Implementation Research. A total of 394 PLHIV (325 in Kampala and 69 in neighboring Wakiso district) were enrolled in the study. Their median age was 52 years (IQR 44-59), and 300 (76%) were female. Only 32% of the participants correctly identified the normal range for systolic blood pressure (BP) (80-140 mmHg) and 24% diastolic BP (60-90 mmHg). Although 87% of the participants recognized that hypertension was treatable, only 62% knew that the treatment was lifelong. Barriers identified through interviews included fragmented care delivery, frequent hypertension medication shortages, interruptions due to side effects, high out of pocket costs of hypertension drugs, use of herbal remedies, and PLHIV discontinuing medication upon feeling better. Integrating chronic care for co-morbidities like hypertension in HIV clinics in Uganda offers an opportunity to address key barriers, including knowledge gaps, inconsistent medication access, and fragmented care delivery. The findings of this formative assessment informed the development of strategies to integrate hypertension-HIV care in Uganda.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0004701"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227863","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":"Organizational models and patient-reported outcomes for palliative care across five tertiary hospitals in Nigeria: An environmental scan.","authors":"Ann Abiola Ogbenna, Matthew Caputo, Tonia C Onyeka, Debora O Ohanete, Lyra S Johnson, Nadia A Sam-Agudu, Chisom Obiezu-Umeh, Babatunde Akodu, Denise Drane, Charlesnika T Evans, Mukaila O Akinwale, Geraldine U Ndukwu, Israel K Kolawole, Saheed A Ayilara, Gracia K Eke, Adeseye M Akinsete, Adeboye Ogunseitan, Ashti Doobay-Persaud","doi":"10.1371/journal.pgph.0004638","DOIUrl":"10.1371/journal.pgph.0004638","url":null,"abstract":"<p><p>Palliative care (PC) is an essential, effective, and affordable component of health care. Global need is rising, with the greatest burden in low-and-middle-income countries. This is especially true in Nigeria where the need is growing rapidly, as are PC services; however, current organizational models have not yet been examined. This was a cross-sectional, descriptive study of five PC sites at tertiary hospitals in four of Nigeria's six geopolitical zones. Surveys, informed by a Centre for Palliative Care, Nigeria (CPCN) needs assessment checklist and the Consolidated Framework for Implementation Research (CFIR), were administered at each site to leadership, frontline workers, patients, and caregivers. Surveys varied by participant group and inquired about organizational models and personal experiences of both providers and recipients of care. Across five sites, there was a total of 282 survey respondents: five leaders, nine frontline workers, 132 patients, and 136 caregivers. The most common diagnoses of PC patients were cancer, sickle cell disease, and HIV. Most sites reported sub-optimal administrative support (80%), hospital management support (60%), and building space (60%). Leadership responses highlighted variations in PC training requirements and opportunities. Frontline workers desired additional training, sponsorship, and governmental support. Most patients and their caregivers reported satisfaction with PC, though high levels of worry and hopelessness were reported. Increased organizational support appears necessary to facilitate improvements in administrative resources, staffing, and training. Emotional and spiritual wellbeing likely require prioritization when designing palliative care delivery services in Nigeria. Further research is needed to refine current services and inform implementation efforts.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0004638"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227881","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":"Iron deficiency prevalence among pregnant women in Cambodia varies widely by trimester, inflammation adjustments, and across different ferritin thresholds.","authors":"Stella C Mlewa, Lulu X Pei, Cassandra Sauer, Colleen C Farrell, Hou Kroeun, Mam Borath, Tim J Green, Kyly C Whitfield, Crystal D Karakochuk","doi":"10.1371/journal.pgph.0004650","DOIUrl":"10.1371/journal.pgph.0004650","url":null,"abstract":"<p><p>Iron deficiency (ID) prevalence has been consistently reported as low among non-pregnant women in Cambodia, but less is known about iron status during pregnancy. Assessing iron status during pregnancy is critical, as deficiency can increase the risk of adverse pregnancy outcomes. We assessed anemia, ID, and inflammation prevalence in a cohort of pregnant women in Cambodia. Venous blood from 90 pregnant women (12-32 weeks' gestation) was collected before the start of a 2016 trial conducted in Prey Veng province. Gestational age was recorded on the same day as blood collection. Hemoglobin was measured on a hematology autoanalyzer, and ferritin, α-1 acid glycoprotein (AGP), and C-reactive protein (CRP) concentrations were measured with a sandwich-ELISA. Ferritin concentrations are presented as unadjusted and inflammation-adjusted (based on AGP and CRP concentrations). ANOVA and post-hoc pairwise t-tests were used to compare variables across trimesters of pregnancy. Mean±SD age of women was 26 ± 5 years. Most women (94%) reported consumption of iron and folic acid (IFA) tablets during pregnancy (mean±SD: 85 ± 19 tablets), and 72% received deworming treatment. Overall, 49% of women had anemia (hemoglobin <110 g/L for first and third trimesters; < 105 g/L for second trimester); with 43%, 34%, and 64% in the first, second and third trimester, respectively. ID prevalence (unadjusted ferritin <30 µg/L) ranged widely by trimester: 0%, 17% and 76% in the first, second and third trimester, as well as with use of a lower ferritin threshold (0-52%; < 15 µg/L), and whether ferritin was inflammation-adjusted (61% with and 43% without adjustment; < 30 µg/L). ID prevalence was high among women in third trimester, despite high IFA compliance. These findings underscore the need to consider the trimester of pregnancy in anemia and ID assessment. More research is needed to determine if trimester-specific thresholds for ferritin in pregnant populations are warranted and whether ferritin should be adjusted for inflammation in pregnancy.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0004650"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227865","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":"Providers perspectives on a team-based maternal health care delivery in Ghana: A qualitative study.","authors":"Veronica Millicent Dzomeku, Ebenezer Dassah, Ebenezer Mensah Gyimah, Abigael Omowumi Emikpe, Lydia Boampong Owusu, Catherine Kroamah Dwumfour, Oluwatoyin Abayomi Ogunyewo, Thomas Peprah Agyekum, Eric Adjei Boadu, Emmanuel Kweku Nakua","doi":"10.1371/journal.pgph.0004246","DOIUrl":"10.1371/journal.pgph.0004246","url":null,"abstract":"<p><p>Interprofessional team-based care is crucial in ensuring respectful and dignified maternal services. However, there is limited research that explores this issue from the perspectives of health care providers in Ghana. The study sought to explore the perspectives and experiences of health care providers working in a collaborative team-based setting at a health in Ghana, with the aim to improve respectful and dignified maternal care. We used a descriptive qualitative study and conducted semi-structured interviews with 35 participants from diverse cadre of health care providers, including Midwives, Nurses, Nutritionists, Pharmacists, Physicians, Radiographers and Sonographers. The data were subsequently transcribed and analysed thematically. The findings revealed four overarching themes namely roles, facilitators, barriers and strategies to overcome barriers experienced by healthcare professionals within an interprofessional team-based setting providing respectful and dignified maternal services. Providers' primary roles in enhancing respectful and dignified maternal services within interprofessional team-based setting included enhancing patients' outcome, improving healthcare professionals' outcomes and optimizing facility outcomes. The facilitators to respectful and dignified maternal care were clear role definitions, transparent communication, personal empathy and professional competence. Conversely, barriers to the delivery of respectful and dignified maternal services within a team-based setting noted in participants' responses included infrastructural deficiencies, inadequate staffing, discrimination and negative professional attitudes. Participants' proposed strategies to overcome these barriers included investments in infrastructure, enhanced professional competence among staff and improved interprofessional communication within and between teams. Addressing these barriers could inform the development of policies and clinical practices aimed at advancing respectful and dignified maternal care. The study can also contribute to the design and formulation of an operational manual required to shape interprofessional team-based respectful and dignified maternal care in Ghana and other similar contexts.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0004246"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227883","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":"Seroprevalence and associated factors of Hepatitis B virus infection among pregnant women attending Antenatal care clinic in public hospitals in the Central Ethiopia region: A cross-sectional study.","authors":"Yilma Markos Larebo, Abebe Alemu Anshebo, Sujit Kumar Behera, Natarajan Gopalan","doi":"10.1371/journal.pgph.0003921","DOIUrl":"10.1371/journal.pgph.0003921","url":null,"abstract":"<p><p>Hepatitis B virus infection poses a significant public health challenge among pregnant women in sub-Saharan Africa, including Ethiopia, where it is often underdiagnosed and underreported. This study aimed to determine the seroprevalence and associated factors of hepatitis B virus infection among pregnant women attending antenatal care in public hospitals in the Central Ethiopian region. A hospital-based cross-sectional study was conducted from October 1, 2023, to March 1, 2024, among 482 pregnant women selected using systematic random sampling. Blood samples were collected and tested for hepatitis B surface antigen, and data were gathered using a structured, interviewer-administered questionnaire. Data were entered into Epi Data version 3.1 and analyzed using SPSS version 26. Logistic regression analysis identified factors associated with hepatitis B infection, with significance at p < 0.05. The response rate was 98.8%. Most participants (66.2%) were aged 18-28 years, with a mean age of 28. The overall seroprevalence of hepatitis B virus infection was 12.8% (95% CI: 10.1, 16.2). A maternal educational level of diploma and above (AOR: 0.23; 95% CI: 0.09, 0.62) and no history of hospital admission (AOR: 0.23; 95% CI: 0.10, 0.53) were linked to a lower risk. In contrast, being unable to read and write (AOR: 2.67; 95% CI: 1.14, 6.26), having a medium (4-6) or large (≥7) family size (AOR: 2.34; 95% CI: 1.15, 4.78) and (AOR: 3.65; 95% CI: 1.33, 10.04), respectively, history of traditional delivery care (AOR: 2.46; 95% CI: 1.04, 5.84), and history of abortion (AOR: 2.90; 95% CI: 1.37, 6.11) were associated with higher risk. Hepatitis B virus infection remains highly prevalent among pregnant women in the study area. Strengthening family-centered healthcare, improving screening and vaccination coverage, and enhancing community-based awareness and prevention initiatives are essential to reduce the burden of infection.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0003921"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217750","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":"The older the injured, the worse the outcomes: A comparison of injury patterns and in-hospital outcomes between younger and older adult trauma patients at a tertiary hospital in Northern Tanzania.","authors":"Edwin Joseph Shewiyo, Rosalia Njau, Natan Nascimento de Oliveira, Frijenia G Sumbai, Paige O'Leary, Frida Shayo, João Vitor Perez Souza, João Ricardo Nickenig Vissoci, Blandina T Mmbaga, Catherine A Staton","doi":"10.1371/journal.pgph.0004547","DOIUrl":"10.1371/journal.pgph.0004547","url":null,"abstract":"<p><p>The number of older adults (>60 years) in Sub-Saharan Africa (SSA) is expected to double by 2050. This demographic shift has led to a rise in traumatic injuries among this population, with one in ten trauma patients in Tanzania being an older adult. Yet, geriatric specialization remains largely absent in many low- and middle-income countries (LMICs), including Tanzania. To inform strategies for optimizing care in this vulnerable group, we conducted a cross-sectional secondary analysis using data from the adult trauma registry at Kilimanjaro Christian Medical Centre (KCMC), a tertiary hospital serving over 15 million people in northern Tanzania. The study included all injured adults (>18 years) from 2020 to 2024. We compared socio-demographic, clinical characteristics, injury patterns, and in-hospital outcomes between older (≥60 years) and younger adults. The main outcomes were length of hospital stay and in-hospital mortality. A total of 3,296 adult trauma patients were included, of whom 13.3% were older adults. Older adults took 4 hours longer to reach care (p < 0.001) and were more likely to be injured by falls (56% vs. 17%), while younger adults were more commonly involved in road traffic crashes (67% vs. 33%) (p < 0.001). Although most older adults sustained mild injuries (86%), they were more often hospitalized (91%) and required surgery (66%) compared to younger adults (85%, 58%) (p = 0.002). Comorbidities were more prevalent in older adults, notably diabetes (12%) and hypertension (26%) (p < 0.001). Older adults also experienced 4 days longer hospital stays and higher in-hospital mortality (9% vs. 4%) than younger adults (p < 0.001).Our study demonstrates significant differences between the injured older adult patients and the younger adult patients, highlighting the differences in care required for older adult trauma patients and providing evidence to support the next steps of adoption and implementation of older adult-specific clinical practice guidelines to improve outcomes.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0004547"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210443","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":"Navigating concurrent public health emergencies: Indigenous perspectives from the Cedar Project in British Columbia.","authors":"Chenoa Cassidy-Matthews, Jorden Hendry, Margo Pearce, Sherri Pooyak, David Zamar, Jeff Reading, Nadine Caron, Martin Schechter, Patricia Spittal, Wayne Christian","doi":"10.1371/journal.pgph.0004658","DOIUrl":"10.1371/journal.pgph.0004658","url":null,"abstract":"<p><p>Connection and resilience are critical to the health and wellbeing of Indigenous Peoples who use drugs (IPWUD): connection to family, cultural supports, safer coping mechanisms and circles of care. Urban IPWUD are more likely to face multiple harms from emergency public health restrictions alongside ongoing toxic drug and housing crises in British Columbia. This paper aims to amplify the experiences of urban IPWUD as they navigated the COVID-19 pandemic and the corresponding public health response in Vancouver and Prince George, BC. Nineteen semi-structured interviews were completed with Indigenous Peoples enrolled in the Cedar Project COVID-19 Study in Vancouver (n = 9) and Prince George (n = 10). Interpretive description was adapted to identify themes across participants' stories. Emerging themes were brought back to participants for member checking using iterative techniques. Interviews were conducted in person between March-May 2022. The median age of participants was 36, with 37% men and 63% women. Four themes were identified: 1) Enduring impacts of colonialism worsened pandemic-related stress for Indigenous Peoples, led to 2) Cycles of isolation, uncertainty and crisis destabilized Indigenous Peoples, and 3) Fear and Trauma-Driven Distrust amplified experiences of grief and loss amidst conflicting public health protocols. However, 4) Resilience and connection were important buffers against pandemic-related harm. Urban IPWUD face ongoing public health emergencies that threaten daily security, safety, and health. This study demonstrated the complex ways Indigenous People navigated COVID-19 and concurrent emergencies, and the challenges they faced. These findings shed light on the ongoing discrimination against urban IPWUD, and reiterate that they are the experts in their own needs and determining how to best survive and thrive through health emergencies.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0004658"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210372","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":"A comparative analysis of factors associated with modern contraceptive use among youth in Northern and Southern Nigeria: A cross-sectional population-based survey (2011-2021).","authors":"Olaniyi Felix Sanni, Abike Elizabeth Sanni, Collins Isioma Onyeagwaibe, Tukwasi Ahamuefula, Oluwadare Peter Akeju","doi":"10.1371/journal.pgph.0004685","DOIUrl":"10.1371/journal.pgph.0004685","url":null,"abstract":"<p><p>Contraceptive use among youth in Nigeria is crucial for improving reproductive health. Despite global advancements, barriers related to sociodemographic, cultural, and religious factors hinder access to family planning services. This study investigates a comparative analysis of factors associated with modern contraceptive use (MCU) among youth in Northern and Southern Nigeria. Data were sourced from Nigeria's Multiple Indicator Cluster Surveys (MICS) for 2011-2021. A retrospective cross-sectional analysis was performed on adolescents and young women aged 15-24. Descriptive statistics assessed contraceptive prevalence. Logistic regression models evaluated associations between contraceptive use and sociodemographic factors such as age, marital status, education, wealth, and region. Southern Nigeria had higher education levels (85.7% with secondary or higher education) and MCU rates (12.6%), compared to Northern Nigeria (50.7% with secondary or higher education; MCU rate of 3.9%). Wealth was a significant factor in the North (AOR = 2.233, p < 0.001), while education emerged as a strong predictor of MCU in both regions. Religious influence was more pronounced in the South, where Christians were significantly more likely to use contraceptives (AOR = 2.670, p < 0.001).The study highlights the need for region-specific interventions to address the disparities in MCU. In Northern Nigeria, targeted efforts should focus on improving education and socioeconomic conditions while addressing cultural and religious barriers to contraceptive use. Continued support for education and family planning services is essential to maintain and enhance MCU rates in Southern Nigeria. Policymakers should prioritize these tailored approaches to promote equitable access to contraceptives and improve reproductive health outcomes across Nigeria.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0004685"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210357","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":"Retrospective analysis of dengue-related fatalities in Nepal, 2022.","authors":"Shashi Kandel, Gokarna Dahal, Chuman Lal Das, Susmita Thapa, Ajit Kumar Karna, Ashna Parajuli, Riju Aryal, Khin PaPa Naing, Nancy Lama, Bandana Pandey, Prabesh Ghimire, Rudra Prasad Marasini","doi":"10.1371/journal.pgph.0004694","DOIUrl":"10.1371/journal.pgph.0004694","url":null,"abstract":"<p><p>Dengue is a mosquito-borne acute febrile illness, also known as break bone fever, and is a major public health problem in the tropics and subtropics worldwide. Understanding the factors that contribute to dengue-related mortalities is crucial for decision-making and implementing effective strategies for prompt patient care. This retrospective analysis aimed to understand the clinical characteristics as well as associated infections and co-morbidities related to dengue fatalities in Nepal. Additionally, this insight aids in developing targeted public health interventions to save lives, enhancing disease surveillance systems, and fostering community awareness about dengue prevention. We conducted a retrospective study of the dengue-related deaths in Nepal reported to the Epidemiology and Disease Control Division between 01 January and 30 November 2022 through early warning and reporting system. Medical records of 88 patients who died from dengue were collected and reviewed from 23 hospitals of Nepal. Among 88 deaths that were reviewed, 47 (53.4%) were males and 41 (46.6%) were females. Of all the death cases reviewed, 26% experienced septic shock, 23% had multiple organ dysfunction syndromes, 20% had a cardiopulmonary arrest, 15% had acute respiratory distress syndrome, and 5% had severe gastro-intestinal bleeding, before the death. Fatality from severe dengue were in 46 cases (52%), from dengue associated with other diseases were in 23 cases (26%), and from dengue associated with co-morbidity complications were in 19 cases 22%. Dengue-related mortality in Nepal disproportionately affected older adults with underlying health conditions and co-infections. Late presentation and rapid clinical deterioration were common. Strengthening early diagnosis, timely referral, and clinical management, particularly for high-risk groups is essential. Public awareness of dengue warning signs and prompt healthcare-seeking behavior should be a key component of dengue control strategies.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0004694"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210373","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}