PLOS global public health最新文献

{"title":"Who has never tested for HIV following a community-based distribution of HIV self-test kits? Establishing associated predictors in rural Zimbabwe.","authors":"Wellington Murenjekwa, Kudzai Chidhanguro, Frances M Cowan, Fiona C Lampe, Cheryl Johnson, Amon Mpofu, Getrude Ncube, Owen Mugurungi, Karin Hatzold, Elizabeth L Corbett, Andrew N Phillips, Euphemia Sibanda, Valentina Cambiano","doi":"10.1371/journal.pgph.0004459","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004459","url":null,"abstract":"<p><p>In 2023, Zimbabwe attained the 95-95-95 UNAIDS targets. However, some sub-populations are substantially less likely to have tested for HIV. Knowledge of characteristics of these groups is crucial in designing interventions that address their needs. We estimated the prevalence and predictors of \"never-having tested for HIV\" status following community-based distribution of HIV self-test kits in rural Zimbabwe. We analysed data from a household survey conducted as part of a cluster randomised trial comparing two community-based HIVST distribution models in six rural districts in 2018-19. HIVST distribution was conducted over one month, followed by the household survey after four months. Survey participants aged 16 years and above completed self-administered Audio-Computer-Assisted-Survey-Instrument. Unadjusted and adjusted mixed effect logistic regression was used to identify factors associated with never-having-tested for HIV. Of the 11,076 analysed participants, the median (IQR) age was 32(22,45) years and 54.5% were female. Seventeen percent of participants had never tested for HIV, primarily due to a perceived lack of HIV risk (50%). Never testers were more likely to be: men (adjusted odds ratio [AOR]=1.69;95%Confidence Interval [CI]=1.52-1.87); younger (16-24 years (AOR=3.84; 95%CI=3.23-4.55), 25-34 years (AOR=1.30; 95%CI=1.07-1.59)) and at-least 45 years old: (AOR=2.17; 95%CI=1.80-2.60); having lower levels of education: primary/less (AOR=1.68; 95%CI=1.46-1.98), some secondary (AOR=1.62; 95%CI=1.42-1.86) compared to at least complete secondary, unemployed (AOR=1.39; 95%CI=1.15-1.69); never married (AOR=3.48; 95%CI=2.98-4.07) and previously married (AOR=1.41; 95%CI=1.19-1.68) compared to currently married; having stigmatizing beliefs (AOR=1.42; 95%CI=1.24-1.62); having: low (AOR=1.52, 95%CI=1.32-1.74) and medium (OR=1.53, 95%CI=1.33-1.75) levels of treatment optimism; not participating in household decisions (AOR=1.96; 95%CI=1.70-2.27) and not reporting condomless sex (AOR=2.58; 95%CI=2.31-2.87). The Ministry of Health need to scale up acceptable and targeted interventions to improve HIV testing in different subpopulations which includes but not limited to young people, unmarried, unemployed, those with stigmatizing beliefs and those not participating in decision making.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 4","pages":"e0004459"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065369","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":"Perceptions of barriers and facilitators for cervical cancer screening from women and healthcare workers in Ghana: Applying the Dynamic Sustainability Framework.","authors":"Adwoa Bemah Boamah Mensah, Thomas Okpoti Konney, Ernest Adankwah, John Amuasi, Madalyn Nones, Joshua Okyere, Kwame Ofori Boadu, Felicia Maame Efua Eduah, Serena Xiong, Jeong Robin Moon, Beth Virnig, Shalini Kulasingam","doi":"10.1371/journal.pgph.0003011","DOIUrl":"https://doi.org/10.1371/journal.pgph.0003011","url":null,"abstract":"<p><p>Cervical cancer screening has reduced cervical cancer-related mortality by over 70% in countries that have achieved high coverage. However, there are significant geographic disparities in access to screening. In Ghana, although cervical cancer is the second most common cancer in women, there is no national-level cervical cancer screening program, and only 2-4% of eligible Ghanaian women have ever been screened for cervical cancer. This study used an exploratory, sequential mixed-methods approach to examine barriers and facilitators to cervical cancer screening from women's and healthcare workers' perspectives. These were further informed by the Dynamic Sustainability Framework (DSF), in particular, two domains, namely the practice setting and ecological system. Two convenience samples of 215 women and 17 healthcare personnel were recruited for this study. All participants were from one of three selected clinics (Ejisu Government Hospital, Kumasi South Hospital, and the Suntreso Government Hospital) in the Ashanti region of Ghana. Descriptive analyses were used to group the data by practice setting. Statistical differences in means and proportions were used to evaluate women's barriers to cervical cancer screening. Quantitative findings from the women's survey informed qualitative, in-depth interviews with the healthcare workers and were analyzed using an inductive thematic analysis. The median age of women and healthcare workers was 37.0 years and 38.0 years, respectively. Most women (n = 194, 90.2%) reported never having been screened. Women who had not been screened were more likely to have no college or university education. Practice setting factors included long clinic wait times and distance to the clinic. Ecological system factors identified were population characteristics such as lack of knowledge about available services, shyness when undergoing a clinician-performed pelvic exam, and requiring a spouse's permission before scheduling. These findings highlight the need for non-clinician-based, culturally sensitive cervical cancer screening options such as self-collected HPV tests to increase screening participation in Ghana.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 4","pages":"e0003011"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060204","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":"Self-reported COVID-19 severity among persons with tuberculosis infection in western Kenya, 2021.","authors":"Hellen C Barsosio, Brian Tangara, Joshua Ongalo, Morine Achieng, Tegwen Marlais, Kimberly D McCarthy, Kephas Otieno, Miriam Wanjiku, Julian Matthewman, David Allen, Luke Hannan, Anand Date, Maia Lesosky, Simon Kariuki, Aaron M Samuels, Chris Drakeley, Feiko O Ter Kuile, Taraz Samandari","doi":"10.1371/journal.pgph.0004372","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004372","url":null,"abstract":"<p><p>Whilst a quarter of the world's population is estimated to be infected with Mycobacterium tuberculosis, it is unknown whether TB infection (TBI) increases the risk of severe COVID-19, which is relevant in TB-endemic settings, especially where HIV co-infection is also common. A convenience cohort of symptomatic and asymptomatic COVID-19 patients aged 8-80 years in western Kenya was followed daily for 14 days to assess disease progression using the validated inFLUenza-Patient-Reported-Outcome Plus signs and symptom tool. Nasal swabbing for SARS-CoV-2 was conducted to confirm the virus using polymerase chain reaction. QuantiFERON-TB Gold Plus was used to diagnose TBI. HIV status was based on self-reports. Between January 3, 2021, and January 20, 2022, 373 out of 387 participants had conclusive QuantiFERON results. At baseline, 5.9% (22/373) had self-reported severe COVID-19, 33.2% (124/373) had TBI, and 11.1% (38/341) reported being HIV-infected. Median follow-up of the cohort was 105 days (range 0-368). Self-reported severe COVID-19 was experienced by 10 of 124 (8.1%) participants compared with 12 of 249 (4.8%) without TBI (odds ratio [OR] 1.73, 95% CI 0.73-4.12, p = 0.21). HIV was not associated with self-reported severe COVID-19 (OR 3.13, 0.96-8.77, p = 0.039, adjusted OR 2.77, 95%CI 0.84-7.93, p = 0.070), but age ≥ 50 years was associated with self-reported severe COVID-19 (OR 3.73, 1.47-9.07, p = 0.004, adjusted OR 2.91, 95%CI 1.02-7.69, p = 0.035). One participant died of COVID-19 three days after diagnosis, and another participant developed active TB 128 days after his COVID-19 diagnosis and was successfully treated. Both were QuantiFERON positive. Self-reported severe COVID-19 was associated with older age and not TBI. Our finding that increased age was associated with self-reported severe COVID-19 is consistent with findings in multiple settings around the world.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 4","pages":"e0004372"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044628","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":"Association between national action and trends in antibiotic resistance: an analysis of 73 countries from 2000 to 2023.","authors":"Peter Søgaard Jørgensen, Luong Nguyen Thanh, Ege Pehlivanoğlu, Franziska Klein, Didier Wernli, Dusan Jasovsky, Athena Aktipis, Robert R Dunn, Yrjö Gröhn, Guillaume Lhermie, H Morgan Scott, Eili Y Klein","doi":"10.1371/journal.pgph.0004127","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004127","url":null,"abstract":"<p><p>The world's governments have agreed on actions to address the challenge of antibiotic resistance. This raises the question of what level of national action is associated with improved outcomes, including both slower growth and lower levels of antibiotic resistance. Answering this question is challenged by variation in data availability and quality as well as disruptive events such as the COVID-19 pandemic. We investigate the association between level of national action and temporal trends in multiple indicators related to health system capacity, antibiotic use (ABU), absolute rates of resistance (ABR) and a Drug Resistance Index (DRI). Using the Global Database for Tracking Antimicrobial Resistance (TrACSS) to construct an index of national action, we apply cross-sectional regression across 73 countries to estimate the association between the level of action in 2016 and trends in national indicators (2000-2016). We find that national action is consistently associated with improved linear or categorical trends in all groups of indicators. Reductions are associated with a relatively high action index (range 0-4) for ABU (median 2.8, 25-75% quartile 2.6-3.3), ABR (3.0, 2.4-3.4), and DRI (3.5, 3.1-3.6). These associations are robust to the inclusion of other contextual factors related to socio-economic conditions, human population density, animal production and climate. Since 2016, a majority of both Low- and Middle-Income Countries (LMICs) and High-Income Countries (HICs) report increased action on repeated questions, while one third of countries report reduced action. The main limitations in interpretation are heterogeneity in data availability and in when actions have been implemented. Our findings highlight the importance of national action to address the domestic situation related to antibiotic resistance and indicate the value of both incremental changes in reducing adversity of outcomes and the need for high levels of action in delivering reduced levels of resistance.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 4","pages":"e0004127"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052914","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":"Comparing lagged impacts of mobility changes and environmental factors on COVID-19 waves in rural and urban India: A Bayesian spatiotemporal modelling study.","authors":"Eimear Cleary, Fatumah Atuhaire, Alessandro Sorichetta, Nick Ruktanonchai, Cori Ruktanonchai, Alexander Cunningham, Massimiliano Pasqui, Marcello Schiavina, Michele Melchiorri, Maksym Bondarenko, Harry E R Shepherd, Sabu S Padmadas, Amy Wesolowski, Derek A T Cummings, Andrew J Tatem, Shengjie Lai","doi":"10.1371/journal.pgph.0003431","DOIUrl":"https://doi.org/10.1371/journal.pgph.0003431","url":null,"abstract":"<p><p>Previous research in India has identified urbanisation, human mobility and population demographics as key variables associated with higher district level COVID-19 incidence. However, the spatiotemporal dynamics of mobility patterns in rural and urban areas in India, in conjunction with other drivers of COVID-19 transmission, have not been fully investigated. We explored travel networks within India during two pandemic waves using aggregated and anonymized weekly human movement datasets obtained from Google, and quantified changes in mobility before and during the pandemic compared with the mean baseline mobility for the 8-week time period at the beginning of 2020. We fit Bayesian spatiotemporal hierarchical models coupled with distributed lag non-linear models (DLNM) within the integrated nested Laplace approximation (INLA) package in R to examine the lag-response associations of drivers of COVID-19 transmission in urban, suburban and rural districts in India during two pandemic waves in 2020-2021. Model results demonstrate that recovery of mobility to 99% that of pre-pandemic levels was associated with an increase in relative risk of COVID-19 transmission during the Delta wave of transmission. This increased mobility, coupled with reduced stringency in public intervention policy and the emergence of the Delta variant, were the main contributors to the high COVID-19 transmission peak in India in April 2021. During both pandemic waves in India, reduction in human mobility, higher stringency of interventions, and climate factors (temperature and precipitation) had 2-week lag-response impacts on the [Formula: see text] of COVID-19 transmission, with variations in drivers of COVID-19 transmission observed across urban, rural and suburban areas. With the increased likelihood of emergent novel infections and disease outbreaks under a changing global climate, providing a framework for understanding the lagged impact of spatiotemporal drivers of infection transmission will be crucial for informing interventions.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 4","pages":"e0003431"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047815","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 scoping review examining measurement of anti-transgender stigma in low- and middle-income countries.","authors":"Tamar Goldenberg, Amanda E Tanner, Mohammed Sheikh Eldin Jibriel, Jennifer Toller Erausquin, Sulianie Mertus, Keenan A Phillips, Grayson K Rodgers, Clare Barrington","doi":"10.1371/journal.pgph.0004490","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004490","url":null,"abstract":"<p><p>Globally, transgender and other gender diverse (trans) people experience widespread prejudice, discrimination, violence, and other forms of stigma, which contribute to negative health outcomes. Most anti-trans stigma research has been conducted in high-income countries. Measurement of anti-trans stigma in low- and middle-income countries (LMICs) is important for understanding and improving the health of trans populations globally. Accordingly, this scoping review explores the use of quantitative anti-trans stigma measures in LMICs. This scoping review follows the guidance of the PRISMA extension for Scoping Reviews (PRISMA-ScR) Checklist and examines empirical research with trans populations in LMICs published in English, Spanish, Arabic, and Russian between 2001-2024. Study eligibility criteria included: 1) trans study population, 2) LMIC study location, 3) quantitative or mixed-method study design, and 4) quantitative measurement of anti-trans stigma. The search yielded 82 articles (representing 65 unique studies) from 34 LMICs. Most articles were published since 2018. No articles focused exclusively on trans men. About 62% of articles included a primary focus on stigma; health outcomes primarily examined HIV and mental health. Nearly all articles (95%) measured enacted stigma; other forms of stigma (e.g., internalized and anticipated) were less commonly measured, and structural stigma was only measured in 4 articles. More than half of the articles (55%) measured stigma both broadly and within specific contexts (e.g., from family, in health care). More research exploring anti-trans stigma is needed, especially with trans-masculine and other gender diverse people, measuring outcomes beyond HIV and mental health, and measuring forms of stigma beyond enacted stigma. Expanding and improving measurement of anti-trans stigma in LMICs can improve our understanding of the mechanisms shaping health equity to inform context specific and tailored health interventions to support trans communities worldwide.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 4","pages":"e0004490"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036729","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":"Baseline assessment of front-line health system capacity in vector-borne disease surveillance and response in Papua New Guinea.","authors":"Rachael J Farquhar, Zebedee Kerry, Yasmin Mohamed, Christopher Morgan, Annie Dori, Samuel McEwen, Diana Timbi, Willie Porau, Nakapi Tefuarani, William Pomat, Leo Makita, Moses Laman, Leanne J Robinson","doi":"10.1371/journal.pgph.0004108","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004108","url":null,"abstract":"<p><p>International public health surveillance and timely response cannot exist without strengthened local surveillance and response systems. Supporting front-line healthcare workers to embed the use of innovative electronic health information systems into adaptable and sustainable processes within their contexts is essential for response to ongoing vector-borne diseases (VBDs) and emerging infectious diseases in resource-constrained settings such as Papua New Guinea (PNG). Baseline health service assessments were conducted at eight provinces to inform the implementation of the STRIVE-Tupaia platform. The STRIVE-Tupaia platform is an innovative electronic real-time data aggregation platform in PNG where healthcare workers are able to review, interpret and respond to febrile illness, molecular diagnostic and vector surveillance data to support evidence-based decision making. Baseline health service assessments involved semi-structured interviews and structured observations of facility procedures. Quantitative data were analyzed using Microsoft Excel, while the qualitative data were thematically coded in NVivo12 (QSR International Pty Ltd). A deductive analysis focussed on the health systems barriers and enablers using the WHO's seven component health systems framework. An inductive analysis explored these impacts for vector-borne disease services specifically. Results indicated barriers to VBD reporting, notification and response including limited training, infrastructure challenges, overstretched workforce and limited governance support. Key learnings from STRIVE's baseline health facility assessments have been used to inform the implementation of the STRIVE-Tupaia platform and improve health care workers routine reporting, notification and response to vector-borne diseases in Papua New Guinea.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 4","pages":"e0004108"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061547","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":"Gaps in hypertension and diabetes treatment among people living with and without HIV: Findings from a prospective cohort study in Kenya, Nigeria, Tanzania, and Uganda, 2013-2023.","authors":"Matthew L Romo, Nicole Dear, Trevor A Crowell, Seth Frndak, Ajay P Parikh, Hannah Kibuuka, John Owuoth, Valentine Sing'oei, Jonah Maswai, Emmanuel Bahemana, Victor Anyebe, Zahra Parker, Julie A Ake, J Sean Cavanaugh, Neha Shah","doi":"10.1371/journal.pgph.0004464","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004464","url":null,"abstract":"<p><p>Hypertension and diabetes are increasingly important contributors to morbidity and mortality in African countries, including among people living with HIV (PLWH) who are on lifelong antiretroviral therapy. However, local HIV care programs have historically not included management of noncommunicable diseases. The African Cohort Study enrolls PLWH and people living without HIV (PLWoH) aged 15 years and older who are receiving clinical care at 12 PEPFAR-supported health facilities in Kenya, Nigeria, Tanzania, and Uganda. Participants undergo clinical assessments and medical record review every six months. We defined hypertension as a persistently elevated systolic and/or diastolic blood pressure ≥140/90 mmHg at two consecutive 6-monthly visits or receipt of hypertension medication. We defined diabetes as a single study visit with a fasting plasma glucose ≥7.0 mmol/L and/or non-fasting plasma glucose ≥11.1 mmol/L or receipt of diabetes medication. We computed descriptive statistics for hypertension/diabetes prevalence and treatment and used random intercept models adjusted for demographic and clinical characteristics to examine predictors of untreated hypertension and diabetes. From 2013 through 2023, among 3617 participants, 692 (19.1%) met our definition of hypertension, with a prevalence of 19.5% among PLWH and 17.3% among PLWoH; 276 (39.9%) received hypertension treatment. No significant difference in untreated hypertension was found comparing PLWH with PLWoH (adjusted risk ratio [aRR] 0.93, 95% confidence interval [CI]: 0.84-1.04). Among 3995 participants, 253 (6.3%) met our definition of diabetes, with a prevalence of 6.6% among PLWH and 4.7% among PLWoH; 51 (20.2%) received diabetes treatment. No significant difference in untreated diabetes was found comparing PLWH with PLWoH (aRR 1.01, 95% CI: 0.91-1.12). The high burden of untreated hypertension and diabetes among PLWH and PLWoH highlight the need for integrated non-communicable disease management within existing HIV services and strengthening of primary healthcare systems.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 4","pages":"e0004464"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013027","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 effect of deforestation on COVID-19 transmission to Indigenous peoples in Brazil: A panel fixed-effects analysis before and after vaccination.","authors":"Humberto Laudares, Carolina Batista, Pedro Henrique Gagliardi, Rudi Rocha, Nicolas Ray","doi":"10.1371/journal.pgph.0004527","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004527","url":null,"abstract":"<p><p>Brazil had the second-largest death toll during the COVID-19 pandemic, with indigenous peoples disproportionately affected among ethnic groups. Parallel to the pandemic, Brazil has recorded the highest rate of deforestation globally, with encroachments into Indigenous territories putting climate stabilization and biodiversity at risk. However, the effects of deforestation on COVID-19 transmission to Brazil's Indigenous peoples are unknown. This study shows that during the pre-vaccination period, deforestation partially explains COVID-19 transmission among Indigenous populations. Our main results for the pre-vaccination period indicate that a daily increase in deforestation per km2 is associated, on average, with the confirmation of 0.76 (p < 0.004, 95% CI: 0.240 - 1.276) new daily cases of COVID-19 among Indigenous peoples 14 days after deforestation warnings. Our estimates suggest deforestation explains at least 9.6% of all COVID-19 cases among indigenous populations. The association between the two variables disappears after the vaccination program. Our findings provide empirical evidence on the interplay between environmental degradation and negative health outcomes in a vulnerable segment of society in the context of a pandemic. Furthermore, these findings highlight the importance of the One Health approach to building preparedness for future pandemic threats.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 4","pages":"e0004527"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044014","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 musculoskeletal injury risk and skeletal changes from backstrap loom weaving and traditional embroidery in Chiapas, Mexico.","authors":"Alizé Lacoste Jeanson, Monserrat Romero Morales, Rosa Itzel Flores Luna","doi":"10.1371/journal.pgph.0004574","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004574","url":null,"abstract":"<p><p>Few medical studies are led in places where social security services are almost inexistent, leaving a gap in knowledge about occupational health risks tied to traditional crafts. This study investigates how traditional textile work-specifically embroidery and backstrap loom weaving work-affects the body in the Highlands of Chiapas, where these crafts represent a substantial part of thousands of women daily activity. Using multi-angle video recordings and interviews with adult women skilled in these crafts, the study evaluates musculoskeletal injury risk through biomechanical analysis. It examines movement types, repetition, involved body parts and muscles, and static postures. Tools such as the Rapid Entire Body Assessment (REBA), Standardized Nordic questionnaires, and evaluation of skeletal changes support this assessment. Findings show frequent, repetitive motions in the upper limbs and fingers, often approaching joint mobility limits (e.g., elbows flexed 60-100°, wrists >15°). These are combined with static, physically demanding postures-spine, neck, and legs are under constant strain due to ground-level sitting positions with the hips flexed at 90°, neck >20°, and knees deeply flexed in some cases (cross-legged or kneeling). Potential musculoskeletal injuries include tendinitis, carpal tunnel syndrome, tenosynovitis, bursitis, spinal disc herniation, and spondylolysis. Skeletal changes would mainly affect the hands, wrists, elbows, and spine, with asymmetry in embroidery and more symmetry in backstrap weaving. These may appear as localized entheseal changes and osteoarthritis. The study demonstrates the need of setting out preventive actions to reduce the injuries risk implied by traditional embroidery and backstrap loom weaving crafts. In order to assess actual musculoskeletal changes linked to those activities, a project is underway to examine bone markers specific to textile craftsmanship in ancient peoples of the same Maya area found buried with textile-making tools.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 4","pages":"e0004574"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030526","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}