PLOS global public health最新文献

{"title":"Feasibility and effectiveness of tailored interventions for two populations at high-risk of malaria in Senegal: Koranic school children and gold miners.","authors":"Sarah Gallalee, Demba Kande, Tidiane Thiam, Henry Ntuku, Caterina Guinovart, Laura Merriman, Abiboulaye Sall, Moustapha Cissé, Aichatou Barry Diouf, Mamadou Diop, Baba Camara, Niene Seck, Faith De Amaral, Roly Gosling, Bryan Greenhouse, Yakou Dieye, Jennifer Smith, Adam Bennett","doi":"10.1371/journal.pgph.0004569","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004569","url":null,"abstract":"<p><p>Senegal has made significant progress in reducing the malaria burden over the last decade. However, malaria remains a major cause of morbidity in some regions and key challenges exist among high-risk populations who have high exposure to mosquitos, but low coverage and use of vector control measures and limited access to healthcare. Two identified high-risk populations are goldminers and talibés (Koranic school students). We conducted a controlled pre/post survey to measure the impact of targeted malaria interventions, including expansion of active community case management and distribution of LLINs, on reported LLIN usage and Plasmodium falciparum infection prevalence at mining sites and Koranic schools (daaras) during the high transmission season in Senegal. We randomly assigned four health facility catchment areas in Kaolack (a city with many daaras) and four in Saraya (a district with gold mining sites) to intervention or control groups. Surveys were conducted pre (Oct 2021; n = 1740 talibés and gold miners) and post (Feb 2022; n = 2200) delivery of the intervention package to assess intervention coverage and infection prevalence by rapid diagnostic test and qPCR. We compared infection prevalence and self-reported LLIN usage, by group and arm, between the two time periods using a difference in difference framework with binomial generalized linear mixed models. Among the talibés, the package of interventions was associated with an adjusted 12.6-percentage point relative reduction in RDT-derived malaria prevalence (p < 0.05, adjusted risk difference: -12.6, 95% CI: -2.7, -22.4) and an adjusted 44.0-percentage point increase in reported prior night net use (p < 0.001, aRD: 44.0, 95% CI: 36.3, 51.6) in the intervention group compared to the counterfactual. However, among the gold miners there was no measured association between the package of interventions and these outcomes. While there was high acceptability in both groups, interventions should be tailored to address high mobility amongst gold miners and maximize impact.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 4","pages":"e0004569"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014099","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 double burden: Community health workers in rural Dominican Republic living and working through the epidemiologic transition.","authors":"Eliana G Armora Langoni, Deshira D Wallace, Clare Barrington","doi":"10.1371/journal.pgph.0004378","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004378","url":null,"abstract":"<p><p>The epidemiological transition postulates that over time, the burden of infectious disease declines and is replaced with non-communicable diseases (NCD). Community health workers (CHW) work on prevention and treatment of infectious and NCD in low-resource settings in the context of health transitions. We explored CHWs' experiences working through the epidemiologic transition in rural Dominican Republic and how the transition impacted their roles and communities. We conducted two semi-structured interviews each with eight CHWs. We analyzed interviews using narrative summaries and thematic coding. CHWs described themselves as change makers that drove health improvements, including child mortality reductions and advancements in social determinants of health. However, more than a transition from infectious disease to NCD, participants described a current double burden of both, and a resulting expansion of their roles and responsibilities. Increased workloads and poor remuneration, layered on top of gendered roles and expectations, were identified as threats to CHW sustainability, efficacy, and well-being. CHWs need additional support to continue their essential role strengthening the health profile of communities in transition.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 4","pages":"e0004378"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001724","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":"Air pollution exposure, respiratory consequences, and perceptions among urban African children living in poor conditions - A case study in Abidjan, Côte d'Ivoire.","authors":"Auriane Pajot, Marie Yapo, Sarah Coulibaly, Madina Doumbia, Sylvain Gnamien, Kouassi Kouao, Stéphane Ahoua, Sonia Adjoua Dje, Cathy Liousse, Raoul Moh, Joanna Orne-Gliemann, Flore Dick Amon Tanoh, Olivier Marcy, Véronique Yoboue","doi":"10.1371/journal.pgph.0003703","DOIUrl":"https://doi.org/10.1371/journal.pgph.0003703","url":null,"abstract":"<p><p>Air pollution can severely impact child lung health but is often not considered a public health priority by policy-makers and population in low-and-middle income countries. We conducted an interdisciplinary mixed method study to assess exposure to air pollution and respiratory health on children aged 5-10 living in poorly condition in Yopougon, a district of Abidjan, Côte d'Ivoire, and to evaluate parent and child perceptions and knowledge of air pollution. We measured pollution exposure with indoor and outdoor PM10 and PM2.5 concentrations and questionnaires, assessed children's respiratory health with ISAAC questionnaire, clinical evaluation, spirometry or RINT, depending on their ability to perform a forced expiration, their perception of air pollution with a \"Draw and express yourself\" activity and that of parents with semi-structured interviews and questionnaires. We enrolled 124 children from 65 households, that used mixed cooking with gas and charcoal in settings with important environmental air pollution. Median 48-hour PM10 and PM2.5 concentrations were 126.7 (IQR: 82.7) and 60.8 (IQR: 50.7) μg/m3, indoor respectively, and 113.4 (IQR: 64.2) and 58.2 (IQR: 36.9) μg/m3, outdoor in courtyards. 21 (16.9%) children reported wheezing in the previous year, 65 (52.4%) reported dry cough at night, and 63 (72.4%) had lung function impairment on spirometry with 24 (27.6%) asthma, 19 (21.8%) non reversible obstruction and 20 (23.0%) restrictive pattern. Adults and children were able to identify visible sources of air pollution but largely ignored effects on health. Despite high exposure to air pollution with particulate matter concentrations significantly exceeding WHO recommendations, and a high prevalence of respiratory symptoms, lung function impairment and asthma, among children, children and adults, perception of air pollution as a health issue was very limited. Recommendations and awareness-raising for parents and children, starting at primary school, are needed to limit the exposure to air pollution and its respiratory consequences.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 4","pages":"e0003703"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058002","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":"Prevalence of hypertension among Patients Seeking Care in selected health facilities in the Southern Province of Sierra Leone.","authors":"Samuel Maxwell Tom Williams, Sahr Foday, Richard Wadsworth, Ibrahim K Foday, Esther Marie Williams, George Mayeh Fefegula, Mohamed S P Koker","doi":"10.1371/journal.pgph.0003281","DOIUrl":"https://doi.org/10.1371/journal.pgph.0003281","url":null,"abstract":"<p><p>Hypertension is a multifactorial disease caused by various environmental, lifestyle, and genetic factors. Hypertension is a major contributor to cardiovascular mortality in Sierra Leone, with the prevalence estimated to be 29.4% among males and 31.6% among females. The study aimed to determine the prevalence of high blood pressure among people seeking medical treatment at four health facilities in the southern province of Sierra Leone.We obtained anonymized individual records of blood pressure measurements from four health facilities (Njala University Hospital, Dandabu CHC, Futa Pejeh CHC, and Njala University Teaching Health Center). A total of 1,793 outpatient records were collected. Linear regression was used with age (years) and sex as independent variables. The total prevalence of hypertension in our study was 36.8%. The average male patient was an adult (37.5 years) with healthy blood pressure (123/75.4 mm/Hg). The average female patient was relatively young (27.6 years) with healthy blood pressure (113.8/72.8 mm/Hg). Age and sex significantly affect the increase of blood pressure in the study. Based on this finding, we recommend the improvement of healthcare infrastructure and affordable antihypertensive medication for all patients.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 4","pages":"e0003281"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045466","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":"Barriers to and facilitators of linkage to care following hypertension and diabetes screening among health workers in Zimbabwe: A mixed method study.","authors":"Leyla Larsson, Rudo M S Chingono, Claire J Calderwood, Farirai P Nzvere, Edson T Marambire, Fungai Kavenga, Sibusisiwe Sibanda, Bridget Kanengoni, Nicol Redzo, Victoria Simms, Chiratidzo E Ndhlovu, Hilda Mujuru, Simbarashe Rusakaniko, Rashida A Ferrand, Kalpana Sabapathy, Katharina Kranzer","doi":"10.1371/journal.pgph.0004513","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004513","url":null,"abstract":"<p><p>The benefits of screening for any condition are only realised if individuals who screen positive link to care services. We investigated linkage to hypertension and diabetes care by healthcare workers accessing a comprehensive health check service. We also explored facilitators and barriers to linkage to care. Between July 2020 and June 2022, a health check with referral and follow-up was offered to healthcare workers (clients) in Zimbabwe. We aimed to understand the proportion that linked to care after referral for an elevated blood pressure and/or HbA1c, assessed by follow-up phone calls. Linkage to care was defined as self-report of having seen a health professional within 30-60 days of the positive screening test result. In-depth interviews were conducted with 15 clients to understand associated facilitators and barriers. Overall, 3,143 clients accessed screening services. The majority were women (75.7%), and median age was 37 (IQR: 28-46) years. 785 (25.0%) clients screened positive for hypertension and 279 (8.9%) screened positive for diabetes. Clients referred for diabetes were more likely to accept referral (n=212, 72.0%) than those referred for hypertension (n=323, 41.1%). Among those referred and successfully contacted for follow-up, 131/182 (72.0%) reported having linked to care for diabetes and 218/269 (81.0%) for hypertension. Distance, accessibility, and travel costs to the facility they were referred to, influenced the decision and ability to link to care. While linkage to care for hypertension and diabetes was high among those who accepted referral, many healthcare workers did not accept referral. Greater awareness among healthcare providers regarding the importance of NCD care to improve acceptance of referral is required and every step of the care cascade must be affordable, accessible, and patient-centred.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 4","pages":"e0004513"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013990","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 the health impacts of implementing a 'Comprehensive Rural Health Project' health system in a low-income region of rural Nepal.","authors":"Fred Barker, Radhakat Jha, Jasmine Morrish, Arbind Sah, Ramesh Choudhary, Richard W Walker, Mike Lavender","doi":"10.1371/journal.pgph.0004458","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004458","url":null,"abstract":"<p><p>Establishing and building grassroots, community-based healthcare systems is a key approach to improving healthcare access sustainably in low-income regions of the world. One prominent early example of this was the Comprehensive Rural Health Project (CRHP), inspiring the framework for subsequent large-scale programs globally. However, many community health projects do not provide the same breadth of services as CRHP, which may have impacts on health outcomes. This qualitative study focused on 12 Dalit villages in rural Nepal following an intervention - known as the Village Alive Project (VAP) - to boost healthcare provision through a CRHP-style health system. Villagers' and health workers' impressions of changes in healthcare access were assessed through 42 semi-structured interviews. Thematic analysis was performed using NVIVO by two independent authors; themes were finalized by reaching consensus. Three generated themes were shared by VAP and control villages: 'changes in access to healthcare services'; 'changes in health promotion and disease prevention' and 'inequalities and their effects on health'. A fourth theme, 'views on the expansion of VAP to non-VAP villages', was generated uniquely for the control group. Lack of health education and sanitation facilities, as well as social stigma, were listed as barriers to health prior to VAP's establishment; most participants felt these have been largely addressed since the arrival of VAP. Implementing more comprehensive primary healthcare on top of pre-existing community-based healthcare systems is feasible, with encouraging findings from this low-income region of rural Nepal. Participants felt VAP improved understanding of diseases such as leprosy, which may benefit future vertical interventions. Improvements in various aspects of health and healthcare were reported for most or all study themes across intervention-group villages; improvements were also noted in control villages but with more evidence of ongoing barriers to health. Further studies looking at key quantitative outcomes are required to triangulate findings.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 4","pages":"e0004458"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045258","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":"Dynamics of factors associated with neonatal death in Madagascar: A comparative analysis of the 2003, 2008, 2021 DHS.","authors":"Sedera Radoniaina Rakotondrasoa, Kadari Cissé, Tieba Millogo, Hajalalaina Rabarisoa, Felix Alain, Seni Kouanda, Julio El-C Rakotonirina","doi":"10.1371/journal.pgph.0003732","DOIUrl":"https://doi.org/10.1371/journal.pgph.0003732","url":null,"abstract":"<p><p>Neonatal mortality remains a major public health challenge, as reductions have stagnated worldwide despite cost-effective interventions in recent years. The temporal evolution of its determinants is insufficiently studied. This study aimed to analyze the dynamics of factors associated with neonatal death in Madagascar between 2003 and 2021. A secondary analysis was conducted using data from the 2003, 2008, and 2021 Demographic and Health Surveys (DHS) of Madagascar. The study population is focused on children under the age of 5 years at the time of these surveys. The death of a newborn within 30 days after birth constitutes the outcome variable. A multilevel binomial logistic regression was performed. The number of children under 5 included in the analysis were 5,415 in 2003, 12,448 in 2008 and 12,399 in 2021. The prevalence of neonatal deaths was 3.1% in 2003, 2.4% in 2008, and 2.6% in 2021. Persistent significant associations with neonatal death were observed for low birth weight, lack of breastfeeding, medium-sized households, large households, and high birth weight. A loss of statistical significance of the association with neonatal death over time was observed for a birth interval of 2-3 years and 4 years and more, mother's age 40-49 years, and use of mosquito net by the mother. In 2021, new significant associations with neonatal mortality were identified in the province of Toliara, absence of geographic barriers to healthcare access, 4-7 ANC visits, and supervised delivery. The factors associated with neonatal mortality, which have worsened over time in Madagascar, include birth weight abnormalities and delivery in the presence of qualified personnel. This deterioration underscores the urgency of improving the quality of perinatal care in healthcare facilities, beyond mere geographical accessibility.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 4","pages":"e0003732"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045531","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":"Sepsis research in Canada: An environmental scan of sepsis investigators, research, and funding.","authors":"Muhadisa Ali, Saad Y Salim, Fatima Sheikh, Alison E Fox-Robichaud","doi":"10.1371/journal.pgph.0003606","DOIUrl":"https://doi.org/10.1371/journal.pgph.0003606","url":null,"abstract":"<p><p>Sepsis is the world's second leading cause of mortality. In 2017, the World Health Assembly declared sepsis a global priority and adopted a resolution prompting member states to improve the prevention, recognition, and management of sepsis. This cross-sectional study examines the sepsis research landscape in Canada, including demographics, scope, and funding. Using convenient sampling, sepsis researchers in Canada were asked to complete an online 20-question survey. We also scanned the CIHR funding database from 2012-2022 to quantify national research dollars spent on sepsis-related projects. Quantitative data was summarized using descriptive statistics, and textual descriptions of current sepsis research activities were analyzed thematically. With a response rate of 46% (69 of the 150), respondents were primarily men (n = 46/69, 67%), who identified as White/European (n = 49/69, 71%), and were professors or clinical professors (n = 36/69, 52%). The predominant areas of research focus were identification of sepsis (n = 21/55, 38%) and treatment/management (29/55, 53%) of sepsis, while sepsis prevention (n = 4/55, 7%) and sepsis education (n = 5/55, 9%) garnered less attention. Past 10 years of CIHR funding data revealed that only 0.7% ($85 million) of total funding ($11 billion) was towards sepsis research, of which only 2 were new-investigator awards. This study illustrates the need for improving the diversity of sepsis researchers in Canada; expanding the scope of research to address sepsis prevention, recovery, and education; and increasing overall funding to sepsis.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 4","pages":"e0003606"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059434","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":"Prevalence of occupational injuries among construction workers in Karachi, Pakistan.","authors":"Asad Allana, Aamir Ali Khan, Muhammad Yousuf, Paul Cullinan, Asaad Ahmed Nafees","doi":"10.1371/journal.pgph.0004578","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004578","url":null,"abstract":"<p><p>The construction industry in Pakistan employs 8% of the labour force, contributing 3% to the national GDP. This study aimed to determine the prevalence and associated factors of occupational injuries among construction workers in Karachi. We conducted a cross-sectional survey among 448 men from 10 construction sites in Karachi between June and October 2022. Workers aged ≥18 years involved in masonry, cleaning, machine operating, and supervision tasks were recruited and completed a structured, interviewer-administered questionnaire. Occupational injury was defined as \"any injury at work over the last year for which the worker sought medical care or took time off work\". We found the prevalence of occupational injury to be 26% (n = 116). Workers from small construction were more likely to report injuries, with an OR of 2.01 (95% CI: 1.30-3.12). Additionally, those working more than 8 hours daily had greater odds of injury, with an OR of 2.30 (95% CI: 1.45-3.67). This study found a high prevalence of injuries among construction workers in Karachi, Pakistan, emphasizing the need for preventive measures and interventions for improving health and safety at construction sites.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 4","pages":"e0004578"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013665","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":"From healthy to unhealthy obesity: A longitudinal study of adults in ELSA-Brasil.","authors":"Fernanda Duarte Mendes, Hully Cantão Dos Santos, José Geraldo Mill, Maria Del Carmen Bisi Molina, Maria de Fátima H Sander Diniz, Carla Romagnolli Quintino, Márcio Sommer Bittencourt, Carolina Perim de Faria","doi":"10.1371/journal.pgph.0004325","DOIUrl":"https://doi.org/10.1371/journal.pgph.0004325","url":null,"abstract":"<p><p>Despite obesity being associated with negative metabolic and cardiovascular outcomes, there is a subgroup of individuals considered healthy. However, there are questions about the stability of the Metabolically Healthy Obesity phenotype. This is a longitudinal study using the ELSA-Brasil cohort, conducted from 2008/10-2017/19 aiming to describe the trajectory of metabolic status of individuals with obesity, as well as the factors associated with the transition into the unhealthy status. Metabolic status was determined using measures of blood pressure, fasting glucose/glycated hemoglobin, triglycerides, and HDL-cholesterol, no previous diagnosis of alteration in any of these parameters nor taking medication to control them. SPSS v.21.0 was used, considering p < 0.05 as significant. The sample consisted of 190 Metabolically Healthy Individuals with Obesity at baseline, of whom 75.8% transitioned to Metabolically Unhealthy status on the third wave of the study. The baseline data indicates that 8.6% of individuals with obesity were metabolically healthy, and in the follow-up, the prevalence was 5.5%. Alcohol use was a risk factor for metabolic status transition [RR: 1.359 (95%CI: 1.005-1.838)]. Also, each 1 cm increase in waist circumference contributed to a 1% increase in the risk of transitioning from healthy to unhealthy metabolic status [RR: 1.011 (95%CI: 1.004-1.018)]. Being a metabolically healthy individual with obesity is a transient state and alcohol consumption as well as increases in waist circumference are risk factors for the metabolic transition.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 4","pages":"e0004325"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061551","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}