Public health challenges最新文献

{"title":"Intention to Receive COVID-19 Vaccination and Its Associated Factors Among Community in Motta Town, North West Ethiopia, 2022: Application of Theory of Planned Behavior.","authors":"Alemnew Getachew, Yosef Wasihun, Nestanet Fentahun, Gebeyehu Lakew","doi":"10.1002/puh2.70383","DOIUrl":"10.1002/puh2.70383","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease-19 (COVID-19) pandemic has significantly impacted global health, with vaccine hesitancy emerging as a major obstacle to controlling the disease. Despite the availability of effective vaccines, many individuals remain reluctant to receive them. This study aims to investigate the factors influencing COVID-19 vaccine intention among the community in Motta town, Ethiopia, using the theory of planned behavior.</p><p><strong>Objectives: </strong>To assess intention to receive COVID-19 vaccine and associated factors among the community in Motta town, North West Ethiopia.</p><p><strong>Method: </strong>A community-based cross-sectional study was conducted among 630 unvaccinated adults in Motta town, North West Ethiopia, from May 15 to June 15, 2022. A systematic random sampling technique was used to select study participants. Data were collected by using interviewer-administered questionnaires and analyzed using descriptive statistics and multiple linear regression. In the final model, a confidence interval (95%) and a <i>p</i> value <0.05 were considered statistically significant.</p><p><strong>Result: </strong>Overall, 310 (49.2%; 95% CI: 45.2%-53.0%) participants intended to receive the COVID-19 vaccine. The mean score of intention was 12.38 with SD ± 5.300. Religion (Muslim) (<i>B</i> = 0.862, <i>p</i> < 0.004), educational status (no formal education) (<i>B</i> = -1.065, <i>p</i> < 0.029), primary school education (<i>B</i> = -0.879, <i>p</i> < 0.038), attitude (<i>B</i> = 0.170, <i>p</i> < 0.000), subjective norm (<i>B</i> = 0.027, <i>p</i> < 0.001), and perceived behavioral control (PBC) (<i>B</i> = 0.029, <i>p</i> < 0.004) were significant factors associated with vaccination intention.</p><p><strong>Conclusion: </strong>Approximately half of the unvaccinated community members intended to receive the COVID-19 vaccine. Religion, educational status, attitude, subjective norm, and PBC were significant predictors of vaccination intention. Public health interventions should focus on improving positive attitudes, strengthening community support for vaccination, enhancing individuals' confidence in accessing vaccination, and addressing access-related barriers to increase COVID-19 vaccine uptake.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 3","pages":"e70383"},"PeriodicalIF":1.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042626","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":"Studying the Comorbidity of Impaired eGFR With Diabetes, Hypertension, and Cardiovascular Diseases in the Tabari Cohort Population.","authors":"Amirhossein Hessami, Farhad Gholami, Motahareh Kheradmand, Reza Alizade-Navaei, Mahmood Moosazadeh","doi":"10.1002/puh2.70385","DOIUrl":"10.1002/puh2.70385","url":null,"abstract":"<p><strong>Background: </strong>This study examines the prevalence and interrelationships of reduced estimated glomerular filtration rate (eGFR) with diabetes mellitus (DM), hypertension (HTN), and cardiovascular diseases (CVDs) within the Tabari cohort population.</p><p><strong>Methods: </strong>A cross-sectional analysis was performed using data from the Tabari cohort, part of the large Prospective Epidemiological Research Studies in Iran (PERSIAN) cohort study. Participants aged 35-70, excluding those with end-stage renal disease or cancer, were included. Reduced eGFR was defined on the basis of a single baseline measurement of eGFR, categorized into G1-G4 stages. The presence of DM, HTN, and CVD was recorded along with demographic and clinical parameters. Statistical analyses included chi-square tests, <i>t</i>-tests, and multiple logistic regressions.</p><p><strong>Results: </strong>Of 9939 participants, 25.5% had reduced eGFR, with prevalence rates of 4.8%, 69.7%, 25.4%, and 0.1% for G1, G2, G3, and G4, respectively. Reduced eGFR was more common with increasing age, in females, and in single/divorced/widowed individuals (<i>p</i> < 0.001). Higher prevalence was also observed among those with lower educational and socioeconomic status, urban residence, retirement or housewife occupational status, and elevated body mass index (BMI), waist circumference, triglycerides, and cholesterol (<i>p</i> < 0.001). HTN, DM, and CVD were more frequent in individuals with reduced eGFR, with increasing prevalence across declining eGFR categories. After adjustment, HTN remained significantly associated with reduced eGFR (adjusted OR = 1.36, 95% CI: 1.21-1.52), whereas associations for DM and CVD were attenuated.</p><p><strong>Conclusion: </strong>A high comorbid prevalence of HTN, DM, and CVD was observed among individuals with reduced eGFR in the Tabari cohort, with HTN emerging as the strongest independent predictor. These findings highlight the importance of early detection and integrated management strategies to prevent further decline in kidney function and associated complications.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 3","pages":"e70385"},"PeriodicalIF":1.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042569","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 Role of Supply Chain Management in Healthcare Waste Management: A Scoping Review on Reverse Logistics, Inventory Control, and Environmental Health Impacts.","authors":"Sikhanyiselwe Nkomo, Maasago Mercy Sepadi, Kabelo Kgarosi, Evans Duah, Kuhlula Maluleke","doi":"10.1002/puh2.70386","DOIUrl":"https://doi.org/10.1002/puh2.70386","url":null,"abstract":"<p><strong>Background and aim: </strong>Efficient healthcare waste management (HCWM), guided by supply chain management (SCM) principles such as reverse logistics (RL), inventory control, and regulation, is essential for reducing environmental and health risks. However, weak supply chain systems, particularly in low-resource settings, continue to undermine sustainability. This scoping review maps how SCM influences HCWM globally, focusing on RL and inventory control, their environmental health impacts, and opportunities to strengthen sustainable waste management systems.</p><p><strong>Methods: </strong>The review followed the PRISMA-ScR guidelines and Arksey and O'Malley framework, structured using the Population-Concept-Context approach. Literature was searched in Scopus, PubMed, Web of Science, and EBSCOhost. The research questions were as follows: (1) How does SCM influence HCWM globally? (2) What roles do RL and inventory control play in shaping environmental health impacts within healthcare systems? Two reviewers independently screened titles, abstracts, and full texts using Covidence, and study quality was assessed using the Mixed-Methods Appraisal Tool.</p><p><strong>Results: </strong>A total of 506 records were identified, of which 21 studies met the inclusion criteria. Findings show that healthcare SCM influences HCWM through interconnected policy, operational, technological, economic, and behavioral domains. Effective inventory control and RL reduce waste and improve resource recovery, whereas weak governance, limited infrastructure, workforce constraints, and low public engagement hinder circular economy (CE) implementation and worsen environmental outcomes.</p><p><strong>Conclusion: </strong>The findings highlight the critical role of SCM in advancing CE practices by promoting waste reduction, traceability, and environmental sustainability. Strengthening regulations, building capacity, and adopting technological innovations are essential to achieving effective and sustainable HCWM.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 3","pages":"e70386"},"PeriodicalIF":1.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042691","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":"Sociodemographic Factors Influencing Knowledge, Attitudes, Practices, Glycaemic Control and Sight-Threatening Retinopathy Among Diabetes Patients in Rawalpindi, Pakistan: A Hospital-Based Cross-Sectional Study.","authors":"Raju Sapkota, M Ahmed Abdullah, Hugo Onumajuru, Shahina Pardhan","doi":"10.1002/puh2.70384","DOIUrl":"https://doi.org/10.1002/puh2.70384","url":null,"abstract":"<p><strong>Aim/objectives: </strong>To examine demographic factors influencing knowledge, attitude and practice (KAP), glycaemic control and sight‑threatening retinopathy (STR) among diabetes patients in Pakistan.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at Al-Shifa Eye Trust Hospital, Rawalpindi, Pakistan, with 517 consecutive diabetes patients (mean age = 63.4 ± 10.5 years). A validated questionnaire in Urdu captured the KAP data. Data on fasting blood glucose (FBG), blood pressure (BP), and STR were also collected. Age, gender, literacy, employment status, diabetes duration, and treatment served as independent variables.</p><p><strong>Results: </strong>Participants showed limited understanding of the importance of controlling BP (51.3%) and cholesterol (64.1%), the risk of blindness due to diabetes (60.0%), and that a diabetic eye test differed from a routine eye test for spectacles (60.9%). These knowledge gaps were more common among older, female, and illiterate individuals. 70.7% of participants reported they would not seek an eye test if they were seeing well, with those with longer diabetes duration (>6 years) more likely to do so (OR = 1.05, <i>p</i> < 0.001). Older age and longer diabetes duration were significantly associated with reduced physical activity (<i>p</i> < 0.001). High FBG levels (>8.5 mmol/L) were significantly associated with older age, illiteracy, and longer diabetes duration. A total of 45.9% of participants had diabetic retinopathy, and 9.9% had STR. Older age (OR = 1.12, <i>p</i> < 0.001), longer diabetes duration (OR = 3.4, <i>p</i> = 0.04), and unemployment (OR = 6.2, <i>p</i> < 0.001) predicted STR significantly.</p><p><strong>Conclusion: </strong>Overall, participants showed inadequate KAP, uncontrolled diabetes, and a high diabetic retinopathy percentage. Older age and longer diabetes duration were consistently associated with poorer KAP, uncontrolled diabetes, and STR. The findings highlight the need for targeted diabetes education and screening programmes to improve awareness and early detection of diabetes-related eye complications in Pakistan.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 3","pages":"e70384"},"PeriodicalIF":1.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042635","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":"Suicide Prevention and the Sustainable Development Goals: The Case of Bangladesh.","authors":"Anisur Rahman Khan, S M Yasir Arafat, Najuwa Arendse","doi":"10.1002/puh2.70382","DOIUrl":"10.1002/puh2.70382","url":null,"abstract":"<p><p>Every year, more than 720,000 people worldwide die by suicide, with a striking 73% of these deaths occurring in low- and middle-income countries (LMICs). The United Nations Sustainable Development Goal (SDG) Indicator 3.4.2 aims to reduce suicide mortality by one-third, yet Bangladesh faces substantial challenges in meeting this benchmark. Although the official 2021 World Health Organization (WHO) estimate places the national suicide rate at 2.8 per 100,000, independent sources suggest a much higher burden of annual deaths-often obscured by misclassification and underreporting. Despite recent advances, such as the National Mental Health Policy (2022) and the National Mental Health Strategic Plan (2020-2030), which targets a 5% reduction by 2025, implementation has stalled. Key obstacles persist, including the ongoing criminalization of suicide attempts, the absence of centralized surveillance data, and lack of a dedicated national prevention strategy. This commentary analyzes the intersection between global SDG targets and the Bangladeshi context, advocating for a multisectoral public health approach. To achieve measurable progress, we emphasize the need for decriminalization, restriction of access to lethal means, responsible media engagement, and increased financial investment in community- and school-based interventions.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 3","pages":"e70382"},"PeriodicalIF":1.8,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027026","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 of <i>Toxoplasma gondii</i>, Rubella Virus, Cytomegalovirus, and Herpes Simplex Virus Among Children and Women in Bhutan's National Referral Hospital: A Cross-Sectional Study.","authors":"Karma Norbu, Sonam Wangzin Rabjay, Karma Galey, Thinley Dorji, Ugyen Chophel, Jamyang Wangmo, Binita Rai, Yeshey Dorjey, Tshokey Tshokey","doi":"10.1002/puh2.70367","DOIUrl":"10.1002/puh2.70367","url":null,"abstract":"<p><strong>Background: </strong>Congenital infections caused by <i>Toxoplasma gondii</i>, rubella virus, cytomegalovirus, and herpes simplex virus (TORCH) infections remain an important but under-documented contributor to adverse maternal and neonatal outcomes in low- and middle-income countries, including Bhutan.</p><p><strong>Objectives: </strong>This study aimed to determine the seroprevalence of TORCH infections among children and women in Bhutan's national referral hospital.</p><p><strong>Methods: </strong>A retrospective cross-sectional review of TORCH antibody test records was conducted at the Jigme Dorji Wangchuck National Referral Hospital for tests carried out between January 2019 and December 2022. The study included all children <18 years and adult women. Serological testing used rapid immunochromatographic assays (OnSite TORCH Panel) to detect immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies, and data were analyzed descriptively with subgroup comparisons by age.</p><p><strong>Results: </strong>A total of 624 participants were included, comprising 359 children (<18 years) and 265 adult females. Among children, 202 (56.9%) were male, and 153 (43.1%) were female. Seropositivity for TORCH infections varied across age groups, with the highest IgG and IgM positivity observed in neonates and infants and a subsequent rise in the reproductive age group. Herpes simplex virus (HSV) showed the highest overall seropositivity (83.8%), followed by cytomegalovirus (CMV) (82.7%), rubella (65.7%), whereas <i>T. gondii</i> had the lowest (14.7%). CMV had the highest IgM (4.8%) and combined IgG/IgM positivity (4.3%).</p><p><strong>Conclusions: </strong>TORCH seropositivity varied across age groups, with HSV and CMV being the most frequently detected infections and IgG antibodies predominating. These findings provide the first baseline TORCH seroprevalence data in Bhutan, which can serve as a reference for future maternal and child health programs.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 3","pages":"e70367"},"PeriodicalIF":1.8,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013254","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":"Climate Justice and One Health Adaptation Policies in Public Health and Disaster Medicine.","authors":"Ioannis Adamopoulos, Aida Vafae Eslahi, Niki Syrou, Konstantina Diamanti, Marilena Katsogiannou, Panagiotis Tsirkas, Maad M Mijwil, Vesna Tornjanski, Harshit Mishra, Elma Hrustemović, Guma Ali","doi":"10.1002/puh2.70370","DOIUrl":"https://doi.org/10.1002/puh2.70370","url":null,"abstract":"<p><strong>Background: </strong>Climate change is intensifying public health risks and placing increasing pressure on disaster medicine systems. These challenges require adaptation strategies that incorporate climate justice principles and the One Health framework.</p><p><strong>Objective: </strong>This scoping review aimed to examine how climate justice and One Health principles are incorporated into public health and disaster medicine adaptation policies.</p><p><strong>Methods: </strong>A scoping review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) guideline using major scientific databases (Scopus, PubMed and Web of Science) and global health organization resources published between 01 January 2005 and 31 October 2025. Critical appraisal of included evidence was assessed using design‑specific tools: the JBI Critical Appraisal Checklist for systematic reviews and the Mixed Methods Appraisal Tool (MMAT) for mixed‑methods studies. Data were synthesized to assess the degree of public health engagement in climate adaptation and the incorporation of climate justice and One Health principles.</p><p><strong>Results: </strong>Out of a total of 19,835 records, eight eligible studies were included. The eight studies comprised six review articles and two mixed‑methods studies, with geographic coverage, including Pakistan, the United States, Greece and multi‑country or global analyses. Findings reveal persistent inequities in climate-related health impacts, particularly among marginalized and resource-limited populations. Health sector participation in national adaptation plans remains limited, with policies often fragmented, mitigation-oriented or insufficiently aligned with One Health principles. Structural inequalities, weak governance, gender disparities and limited multisector coordination hinder equitable adaptation. Climate stressors, including extreme weather events, air pollution, vector-borne diseases and environmental degradation, disproportionately affect communities with the lowest adaptive capacity.</p><p><strong>Conclusions: </strong>There is an urgent need for standardized vulnerability assessment frameworks, stronger multisector collaboration, improved early-warning systems and enhanced capacity building through international public health institutions.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 3","pages":"e70370"},"PeriodicalIF":1.8,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992994","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":"Breaking Trust: How Covid-19 Communication Failures Undermined Public Confidence in US Health Officials-A Narrative Review.","authors":"Matthew L Harrison","doi":"10.1002/puh2.70373","DOIUrl":"10.1002/puh2.70373","url":null,"abstract":"<p><p>National polling shows US citizens increasingly distrust those tasked with making our public health decisions. This dilemma appears to have been driven in part by evolving policy recommendations, communications from health officials and medical agencies that were confusing to some, and seemingly hypocritical behavior among US political leaders during the Covid-19 pandemic. The following review provides a chronological timeline of multiple pandemic-era events as well as communication and behavior missteps potentially responsible for the growing public distrust. It also suggests possible solutions to ameliorate the problem going forward.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 3","pages":"e70373"},"PeriodicalIF":1.8,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984301","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":"Latent Tuberculosis and Associated Factors Among Adults Living With HIV in Kinshasa, Democratic Republic of the Congo: A Cross-Sectional Study.","authors":"José Mutambayi Kadima, Aliocha Natuhoyila Nkodila, Pascal Tshindele Lutumba, Jean-René Kabangu M'buyamba, Placide Kingebeni Mbala, Jeremie Masidi Muwonga, Marie-Joelle Sifa Muchanga, Daniel Mukadi-Bamuleka, Marie-José Bajani Kabedi, Mecky Isaac Matee, Jean Marie Ntumba Kayembe","doi":"10.1002/puh2.70380","DOIUrl":"10.1002/puh2.70380","url":null,"abstract":"<p><strong>Background: </strong>Latent tuberculosis infection (LTBI) is more frequent among people living with human immunodeficiency virus (HIV) (PLHIV), in whom immunosuppression favors reactivation. However, data from sub-Saharan Africa remain limited. This study aimed to determine the prevalence of LTBI and identify its associated factors among adults living with HIV in Kinshasa.</p><p><strong>Methods: </strong>An analytical cross-sectional study was conducted between May 2022 and October 2025 in nine HIV care centers in Kinshasa. Adult HIV-positive patients were consecutively recruited. LTBI was screened using the tuberculin skin test (TST) and/or interferon-gamma release assays (IGRAs). Socio-demographic, clinical, and immunological data, including CD4 cell counts, were collected. Associated factors were identified using multivariate logistic regression at a significance level of <i>p</i> < 0.05.</p><p><strong>Results: </strong>Among 248 participants, 74.7% were women. The mean age was 45.5 ± 10.7 years, and the median CD4 count was 321 cells/µL (IQR: 281-390). Overall, 25.8% were IGRA-positive and 30.6% TST-positive, with 38.3% indeterminate IGRA results. The main factors associated with LTBI were CD4 count <200 cells/µL (IGRA: adjusted odds ratio [aOR] = 3.34; TST: aOR = 3.64), history of positive TST (IGRA: aOR = 2.50; TST: aOR = 2.78), and contact with an active TB case (IGRA: aOR = 2.94).</p><p><strong>Conclusions: </strong>The prevalence of LTBI among adults living with HIV in Kinshasa is high. Severe immunosuppression, prior exposure, and contact with active TB cases are key determinants. These findings highlight the importance of screening and preventive therapy to reduce progression to active tuberculosis.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 3","pages":"e70380"},"PeriodicalIF":1.8,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984332","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":"<i>mcr</i>-Mediated Colistin Resistance in <i>Escherichia coli</i>: A One Health Review of Reported Prevalence Across Human, Animal, Food, and Environmental Sectors.","authors":"Ferdous-Ul-Haque Joy, Tashfiya Zaman Mouree, Munny Das, Asma Kabir","doi":"10.1002/puh2.70376","DOIUrl":"10.1002/puh2.70376","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) is a growing global health problem that threatens the effective treatment of bacterial infections. <i>Escherichia coli</i> is widely used as an indicator organism for monitoring AMR because it circulates among humans, animals, food, and the environment. As resistance to many commonly used antibiotics has increased, colistin has been reintroduced as a last-resort treatment for severe infections caused by multidrug-resistant Gram-negative bacteria. The discovery of plasmid-mediated colistin resistance genes (<i>mcr</i>) has raised serious concern, as these genes can spread easily between bacteria. This narrative review synthesizes findings from 28 selected studies published up to 2025, covering more than 36,000 <i>E. coli</i> isolates collected from human, animal, food, and environmental sources across different regions of the world. <i>mcr</i>-positive <i>E. coli</i> were most commonly reported in livestock and meat products, with moderate occurrences in environmental samples and generally lower prevalence in human clinical isolates, although direct comparisons are limited by substantial study heterogeneity. These findings suggest that food-producing animals and contaminated environments represent important reservoirs of colistin resistance, whereas human exposure may occur through indirect pathways, although prevalence data alone cannot establish transmission directionality. Even with restrictions on colistin use in animal production and improved antimicrobial stewardship in many countries, <i>mcr</i> genes persist due to factors like environmental contamination and co-selection with other resistance genes. This persistence is influenced by environmental contamination, the presence of other resistance genes on the same plasmids, and global trade of food products. The available evidence underscores that colistin resistance cannot be effectively addressed within a single sector. A coordinated One Health approach that integrates human health, animal production, and environmental management is essential to limit the further spread of <i>mcr</i>-mediated colistin resistance and to preserve the clinical value of this critical antibiotic.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 3","pages":"e70376"},"PeriodicalIF":1.8,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984350","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}