PLOS global public health最新文献

{"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}

{"title":"Using a quality improvement approach to improve reporting of malaria deaths in Namutumba District, Eastern Uganda, 2022-2023.","authors":"Marie Gorreti Zalwango, Richard Migisha, Benon Kwesiga, Lilian Bulage, Daniel Kadobera, Alex Riolexus Ario","doi":"10.1371/journal.pgph.0003324","DOIUrl":"10.1371/journal.pgph.0003324","url":null,"abstract":"<p><strong>Background: </strong>Reporting malaria deaths is critical for assessing prevention and case management interventions. In Uganda, malaria mortality is recorded in inpatient registers and reported through weekly and monthly surveillance reports. During a data quality assessment in Namutumba District in October 2022, we found more malaria deaths in health facility registers than were reported. We conducted a continuous quality improvement initiative to improve the accuracy of reported malaria deaths in Namutumba District.</p><p><strong>Methods: </strong>We purposively selected 2 high-level health centers (HC) in Namutumba District that reported malaria deaths during September 2021-October 2022. We formed quality improvement teams (QIT) comprising clinical and statistical staff at the HC. We conducted brainstorming sessions with QITs to identify challenges with reporting malaria deaths, prioritized areas for improvement, and conducted root cause analysis. Using the plan, do, study, act (PDSA) cycle, we identified change ideas to address root causes.</p><p><strong>Interventions: </strong>Challenges included knowledge gaps on malaria death definitions, lack of consequences for failing to document deaths, and unclear guidance on how to document deaths. Sustainable interventions identified included continuous medical education on malaria death definition, one-on-one mentorship of staff on documentation in inpatient registers, and weekly verification of inpatient register data, all implemented during November 2022-February 2023.</p><p><strong>Results: </strong>Of the 36 malaria deaths that occurred during the baseline period (September 2021-October 2022), 25 (69%) were included in the weekly report, and four (11%) in the monthly report. Following the intervention implementation, all 7 malaria deaths recorded at the 2 health facilities during November 2022-February 2023 were reported in the weekly and monthly reports.</p><p><strong>Conclusion: </strong>Continuous medical education, supervision and mentoring of HC staff, and clear and comprehensive guidance on documenting malaria deaths contributed to the improvement in malaria death reporting for HCs in Namutumba District. Consistence in implementation of these improvement activities could enable accurate planning and resource allocation for malaria control strategies.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 6","pages":"e0003324"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210444","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":"Socio-medical factors associated with neurodevelopmental disorders on the Kenyan coast.","authors":"Patricia Kipkemoi, Jeanne E Savage, Joseph Gona, Kenneth Rimba, Martha Kombe, Paul Mwangi, Collins Kipkoech, Eunice Chepkemoi, Alfred Ngombo, Beatrice Mkubwa, Constance Rehema, Symon M Kariuki, Danielle Posthuma, Kirsten A Donald, Elise Robinson, Amina Abubakar, Charles R Newton","doi":"10.1371/journal.pgph.0003806","DOIUrl":"10.1371/journal.pgph.0003806","url":null,"abstract":"<p><p>Neurodevelopmental disorders (NDDs) are a group of conditions with their onset during the early developmental period and include conditions such as autism and intellectual disability. Occurrence of NDDs is thought to be determined by both genetic and environmental factors, but data on the role of environmental factors for NDD in Africa is limited. This study investigates environmental influences on NDDs in children from Kenya. This case-control study compared children with NDDs and typically developing children from two studies on the Kenyan coast. We included 172 study participants from the Kilifi Autism study and 151 from the NeuroDev study who had a diagnosis of at least one NDD and 112 and 73 with no NDD diagnosis from each study, respectively. Potential risk factors were identified using unadjusted univariable analysis and adjusted multivariable logistic regression. Univariable analysis in the Kilifi Autism study sample revealed hypoxic-ischaemic encephalopathy conferred the largest odds ratio (OR) 10.52 [95%CI: 4.04, 27.41] for NDDs, followed by medical complications during pregnancy (gestational hypertension & diabetes, eclampsia, maternal bleeding) (OR=3.17 [95%CI: 1.61, 6.23]). In the NeuroDev study sample, labour and birth complications (OR=7.30 [95%CI 2.17, 24.61]), neonatal jaundice (OR=5.49 [95%CI 1.61,18.72]) and infection during pregnancy (OR= 5.31 [95%CI 1.56, 18.11]) conferred the largest risk associated with NDDs. In the adjusted analysis, seizures before age 3 years in the Kilifi Autism study and labour and birth complications in the NeuroDev study conferred the largest increased risk. Higher parity, the child being older and delivery at home were associated with a reduced risk for NDDs. Recognition of important risk factors such as labour and birth complications could guide preventative interventions, developmental screening of at-risk children and monitoring progress of these children. Further studies examining the aetiology of NDDs in population-based samples, including investigating the interaction between genetic and environmental factors, are needed.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 5","pages":"e0003806"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188609","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":"Decentralized TB diagnostic testing with Truenat MTB Plus and MTB-RIF Dx vs. hub-and-spoke GeneXpert MTB/RIF Ultra in Mozambique and Tanzania: a cost and cost-effectiveness analysis.","authors":"Akash Malhotra, Délio Elísio, Antonio Machiana, Anange Lwilla, Jerry Hella, Neenah Young, Celso Khosa, Marta Cossa, Dinis Nguenha, Regino Mgaya, Dionisia Balate, Mikaela Watson, Vinzeigh Leukes, Lelisa Fekadu, Saima Bashir, Adam Penn-Nicholson, Morten Ruhwald, Leyla Larsson, Monisha Sharma, Katharina Kranzer, Claudia M Denkinger, David Dowdy","doi":"10.1371/journal.pgph.0004724","DOIUrl":"10.1371/journal.pgph.0004724","url":null,"abstract":"<p><p>In low-and middle-income countries, missed or delayed tuberculosis (TB) diagnoses contribute to avoidable morbidity, mortality, and transmission. Decentralized testing platforms, such as the Molbio Truenat, may offer solutions by providing accurate point-of-care testing, improving access, and lowering out-of-pocket costs. Despite these advantages, the overall cost and cost-effectiveness of identifying additional TB cases using the Truenat MTB assays remain inadequately explored and understood. We collected economic data from a multicentre randomized controlled trial of TB testing using decentralized Molbio Truenat platform with MTB Plus and MTB-RIF Dx assays (Truenat MTB assays) versus hub-and-spoke Xpert MTB/RIF Ultra (standard of care) in Tanzania and Mozambique (TB-CAPT Core trial). We estimated facility-based diagnostic cost per participant tested and incremental facility-based diagnostic cost per incremental participant initiating TB treatment within seven and sixty days from enrolment. We used the societal perspective and conducted sensitivity analyses to determine key drivers of cost-effectiveness. The facility-based diagnostic cost per participant initiating treatment within seven days from enrolment in Mozambique was $853(95% uncertainty range: $707, $1072) for hub-and-spoke testing and $690($588, $823) for decentralized testing; in Tanzania costs were $596($485, $746) for hub-and-spoke testing and $592($495, $715) for decentralized testing. At sixty days, costs per treatment initiation were $581($493, $706) for hub-and-spoke vs. $678($576, $811) for decentralized testing in Mozambique, and $391($324, $476) vs. $591($494, $716) in Tanzania. Comparing decentralized to hub-and-spoke testing, the incremental cost per incremental seven-day treatment initiation was $403(-$103, $941) in Mozambique and $580($167, $1638) in Tanzania, and $805(-$10107, $10560) and -$353(-$20299, $20802) for sixty-day treatment initiation, respectively. Utilization (i.e., testing volume) of decentralized equipment was the strongest driver of cost-effectiveness. Decentralized TB testing with Truenat MTB assays is cost-effective relative to hub-and-spoke testing in Mozambique and Tanzania.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 5","pages":"e0004724"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188608","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 viral suppression in children aged 9 years or younger on dolutegravir-based antiretroviral therapy in Malawi, a mixed-methods study.","authors":"Khumbo Phiri, Christine Hagstrom, Eric Lungu, Kelvin Balakasi, John Songo, Amos Makwaya, Deanna Smith, Anteneh Worku, Risa Hoffman, Sam Phiri, Kathryn Dovel, Joep J van Oosterhout","doi":"10.1371/journal.pgph.0004510","DOIUrl":"10.1371/journal.pgph.0004510","url":null,"abstract":"<p><p>After the transition to pediatric dolutegravir-based regimens, viral load (VL) suppression among children with HIV (CWH) in Malawi has remained suboptimal. This mixed-methods study assessed factors associated with high VL among young CWH on dolutegravir-based antiretroviral therapy (ART) and explored adherence barriers from primary-caregiver and healthcare worker perspectives. Between April-July 2023, we performed an unmatched case-control study at 49 Malawian health facilities. We included CWH aged ≤9 years, on dolutegravir-based ART, with a routine VL test-result that was high (≥1,000 copies/mL) for cases, or suppressed (<200 copies/mL) for controls. Using mixed-effect modified Poisson regression, we determined factors associated with high VL, adjusting for sex, site and district. To assess adherence barriers, we conducted in-depth interviews (IDIs) with randomly selected caregivers of CWH with high VL and with healthcare workers providing pediatric HIV care. Data were analyzed using a hybrid thematic approach that combined deductive and inductive coding strategies. We enrolled 538 CWH: 222 cases, with high VL and 316 controls, with suppressed VL. Duration on ART > 4 years (aRR = 0.86, 95% CI: 0.77-0.95) and ≥2 interruption in treatment episodes (≥28 days late for clinic appointment) in the 12 months before VL sample collection (aRR = 1.47, 95% CI: 1.28-1.68) were significantly associated with high VL. Through 54 IDIs (30-caregivers, 24-healthcare workers), five key adherence challenges were identified and affected the children ≤5 years the most: resistance to daily medication, difficulties taking multiple pills, food insecurity, fear of unintentional disclosure, and inability to attend clinic appointments consistently. This study highlights that behavioral, socio-economic and psychosocial factors influences ART adherence among CWH. Duration on ART and recent interruptions in treatment were associated with high VL, stressing the need for targeted interventions that will require health-system and client-level approaches to improve VL suppression among CWH in Malawi and similar settings.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 5","pages":"e0004510"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188606","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":"Death of backcountry winter-sports practitioners in avalanches - A systematic review and meta-analysis of proportion of causes of avalanche death.","authors":"Guang Rong, Lauri Ahonen, Gerit Pfuhl, Benjamin Ultan Cowley","doi":"10.1371/journal.pgph.0004551","DOIUrl":"10.1371/journal.pgph.0004551","url":null,"abstract":"<p><p>This study estimates the proportions of the three major causes of avalanche death globally, and reviews potential factors influencing the proportions of causes of avalanche-related deaths (PCAD). By searching databases and consulting experts, we retrieved studies and registries in multiple languages, which examined PCAD. As a result, we retrieved 1,415 reports and included 37 for the study (22 for meta-analysis). We performed a meta-analysis to estimate pooled proportions. Between-study heterogeneity was assessed jointly by [Formula: see text] and 95% prediction interval of pooled estimates. PCAD by trauma and asphyxia are 29% (95%CI 21-39%) and 82% (95%CI 72-88%), after the year of 2000. PCAD by hypothermia is 2% (95%CI 1-4%), estimated with studies having sufficient sample size. Time periods (before or after 2000), data representativeness (national subgroup), forensic procedures, and sample size explained between-study variation for proportions to a considerable extent. Factors influencing PCAD, that were either available or not available for quantitative synthesis, were summarized in a narrative systematic review (37 studies). In conclusion, we re-affirm asphyxia as the predominant cause of avalanche death, followed by trauma, and then hypothermia. Patterns of PCAD by trauma and asphyxia varied more after the year of 2000. A sample size > 75 is needed to estimate the proportion of hypothermia. PCAD discrepancies are lower in the data representing fatalities from a country than from regions. Without proper forensic diagnosis procedure, PCAD by trauma can be over-estimated. Under-reporting of forensic diagnostic criteria is an important bottleneck to the reliability of evidence in the field. Evidence on the role of other influencing factors to PCAD such as fatalities' expertise and usage of mitigation gear is anecdotal and warrants further research. The results of meta-analysis build upon synthesizing and summarizing studies with moderate to high risk of bias and should be interpreted with caution.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 5","pages":"e0004551"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188607","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":"Neurodevelopmental delay and associated factors among preterm infants aged 6 to 24 months adjusted gestation age in two urban hospitals in Uganda.","authors":"Joyce Nalwoga, Victoria Nakibuuka, Leonard Manirakiza, Tracy Tushabe Namata, Robert Sebunya","doi":"10.1371/journal.pgph.0004361","DOIUrl":"10.1371/journal.pgph.0004361","url":null,"abstract":"<p><p>Neurodevelopmental delay has been reported among preterm infants who survive beyond the neonatal period. However, there is paucity of data regarding neurodevelopmental outcomes in preterm infants in Africa, including Uganda. This study aimed to determine the prevalence and factors associated with neurodevelopment delay (NDD) in preterm infants aged 6-24 months of adjusted gestation age. A cross-sectional study was conducted among 206 preterm infants, aged between 6 and 24 months of adjusted gestation age in the preterm follow up clinics at St. Francis Hospital Nsambya and Mulago Specialized Women and Neonatal Hospital in Kampala-Uganda from 25th January 2021-25th January 2022. The prevalence of NDD was 13.6% (28/206), with social delay comprising 12.1% (25/206), fine motor delay 11.7% (24/206), language delay 10.7% (22/206) and gross motor delay 7.8% (16/206). Significant factors associated with NDD included microcephaly [aPR = 6.2, CI: 2.6-33.5, P < 0.001], severe acute malnutrition (SAM) [aPR = 4.6, CI: 1.87-12.56, P = 0.021], incomplete immunization [aPR = 2.8, CI: 1.23-4.76, P = 0.013], neonatal sepsis [aPR = 3.8, CI: 1.1-9.3, P = 0.026], neonatal hypoglycemia [aPR = 6.2, CI: 1.8-16.4, P = 0.002], lack of caretaker social support [aPR = 8.3, CI: 2.43-37.9, P = 0.002] and large family size (≥5 children) [aPR = 6.8, CI: 2.24-22.7, P = 0.002]. NDD affects 13.6% of preterm infants, with the social and fine motor delays being most prevalent. Modifiable factors like malnutrition, lack of caretaker social support and incomplete immunization should be screened and addressed to reduce NDD among preterm infants in Uganda.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 5","pages":"e0004361"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181378","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":"Exploring gender stereotypes and norms among peri-urban very young adolescents in Zimbabwe using participatory and qualitative approaches.","authors":"Owen Nyamwanza, Tariro S Bikwayi, Tariro Chinozvina, Leviticus Makoni, Farai Muronzi, Maxwell Changombe, Angela Obasi, Talent Makoni, Sinokuthemba Xaba, Owen Mugurungi, James R Hargreaves, Frances M Cowan, Webster Mavhu","doi":"10.1371/journal.pgph.0003845","DOIUrl":"10.1371/journal.pgph.0003845","url":null,"abstract":"<p><p>Gender stereotypes and norms shape very young adolescents' (VYAs, 10-14 years old) behaviours, including in relation to sexual and reproductive health (SRH). This formative study sought to determine and prioritise the stereotypes and norms to be targeted as part of work to co-develop a gender-transformative intervention for VYAs in Zimbabwe to promote positive masculinities and SRH. In 2023, we collected data from VYAs, using participatory workshops encompassing various activities. We also held focus group discussions with older adolescents and parents/guardians, and individual interviews with community influencers. We used interpretive thematic analysis to generate themes across data. We later presented research findings to diverse stakeholders to explore how the findings might influence the design of our gender-transformative intervention. Gender stereotypes emerged in relation to sexual behaviour and SRH norms. Both boys and girls seemed to condone boys' multiple, concurrent relationships. Boys were deemed to be unable to control their sexual urges. Menstrual stigma, myths and misconceptions were pervasive. Stereotypes were also evident in beliefs and norms around resource and task allocation. For example, both boys and girls concurred that given limited resources, educating a boy child should be prioritised even when a girl sibling is performing better academically. Stereotypes relating to labour distribution were also evident. Daily activity charts suggested longer working hours for girls. Differential attitudes towards drug and substance use among boys and girls were driven by underlying masculine norms. Of note, adolescents disapproved of some of these norms, pointing to an opportunity to shift them. Stakeholders highlighted the need for our planned intervention to focus on the wider community, in addition to VYAs themselves. The formative research enabled us to identify key gender stereotypes and norms, information which is critical for informing the planned gender-transformative intervention. Although deeply seated, these stereotypes are not insurmountable, particularly among VYAs.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 5","pages":"e0003845"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183370","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":"HIV prevalence, risk factors, prevention methods, and interventions among taxi drivers and commercial motorcyclists in sub-Saharan Africa: A scoping review.","authors":"John Baptist Asiimwe, Benjamin Betunga, Lilian Birungi, Joy Kabasindi Kamanyire, Moses Wankiiri, Lilian Nuwabaine, Joseph Kawuki, Edward Kumakech","doi":"10.1371/journal.pgph.0004239","DOIUrl":"10.1371/journal.pgph.0004239","url":null,"abstract":"<p><p>Transport workers, particularly taxi drivers and commercial motorcyclists, comprise a population at high risk for HIV and account for nearly one-third of new HIV infections in sub-Saharan Africa (SSA). Transport workers bridge HIV infections from high-risk populations to the general population. This scoping review aimed to map the available evidence around HIV prevalence, risk factors, prevention methods, and interventions among taxi drivers and commercial motorcyclists in SSA. This scoping review used the Arksey and O'Malley framework. Published articles were retrieved from MEDLINE, CINAHL, African Index Medicus, Web of Science, Scopus, EMBASE, HINARI, and Google Scholar from January 2000 to August 2024. Two authors screened the titles and abstracts of retrieved studies and examined the references of relevant articles for additional literature. Three authors independently extracted data from the included studies using a standard data extraction form. Data were analyzed using descriptive statistics and content analysis techniques. This review included 24 out of 126 studies. The HIV prevalence was 2.02%-9.9% among commercial motorcyclists and reached 33.4% in samples comprising both motorcyclists and taxi drivers. The high HIV infection rate in SSA when compared with the global adult general population was associated with numerous behavioral (e.g., multiple sex partners), psychosocial (e.g., stigma), and sociodemographic (e.g., age) risk factors. However, there was suboptimal use of HIV prevention methods such as safe male circumcision (20.7%-64.9%) and condoms (26%-45.7%) and few interventional studies (n = 2). Despite HIV testing being an entry point for chronic care, we found no study reporting the HIV cascade for commercial motorcyclists or taxi drivers with HIV. To inform better HIV policies and programs in SSA this review recommends additional observational and interventional research on HIV incidence, predictors, new models of HIV testing, antiretroviral-based HIV prevention methods, and the role of peer-to-peer support models in reducing HIV infection.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 5","pages":"e0004239"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182882","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":"Dietary diversity insufficiently explains differences in prevalence of anaemia in pregnancy across regions in Nigeria: A secondary analysis of Demographic and Health Survey 2018.","authors":"Ochuwa Adiketu Babah, Diana Sagastume, Opeyemi Rebecca Akinajo, Giulia Scarpa, Claudia Hanson, Elin C Larsson, Bosede Bukola Afolabi, Lenka Beňová","doi":"10.1371/journal.pgph.0004540","DOIUrl":"10.1371/journal.pgph.0004540","url":null,"abstract":"<p><p>The prevalence of anaemia in pregnancy differs across regions worldwide. Previous studies have reported associations between diet and anaemia. Dietary intake may be affected by regional factors like culture, food production and availability. However, in Nigeria, the association between dietary diversity and region in the context of anaemia prevalence among pregnant women is unclear. This study compared the prevalence of anaemia in pregnancy across regions in Nigeria and determined the association between dietary diversity and anaemia across the regions. It was across-sectional study of 1,525 pregnant women aged 15-49 screened for anaemia in Nigeria's Demographic and Health Survey 2018. The primary outcome was anaemia (haemoglobin concentration < 11g/dl, irrespective of trimester). The explanatory variable was minimum dietary diversity for women (MDD-W) defined as the consumption of at least five out of ten food groups on the day preceding the interview, stratified by region. Logistic regression analyses were used to determine the association between dietary diversity and anaemia in pregnancy by region. The prevalence of anaemia in pregnancy was 61.1% and it ranged from 55.2% in South-West to 71.1% in South-East region, p = 0.038. Less than half of pregnant women met the MDD-W requirement (45.8%). There was a significant crude association between MDD-W and anaemia, OR: 0.78 (95%CI: 0.60 - 0.99), which was lost when confounders were included, aOR: 0.85 (95%CI: 0.66-1.10). Compared to North-West region, anaemia in pregnancy was significantly higher in North Central region aOR:1.90 (1.14-3.16). The model with an interaction term between MDD-W and region was not a better fit for the data (LRtest p < 0.001) in multivariable model. In conclusion, the prevalence of anaemia in pregnancy is high in Nigeria and varies across regions, not only due to dietary diversity. Region is not an effect modifier of the association between MDD-W and anaemia.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 5","pages":"e0004540"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183462","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}