Public health challenges最新文献

{"title":"Social Isolation, Acculturative Stress, and Resilience Among Older Asian Indian Immigrants in the United States: A Qualitative Study.","authors":"Malinee Neelamegam, Shilpa Patil, RoiSan Nhpang, Sarah Alkhatib, Anika Gupta, Nolan Kline, Stacey Griner","doi":"10.1002/puh2.70365","DOIUrl":"10.1002/puh2.70365","url":null,"abstract":"<p><strong>Background: </strong>Social isolation and loneliness are increasingly recognized as public health concerns for aging populations, yet the experiences of older Asian Indian immigrants in the United States (US) remain understudied. This qualitative study explored how immigration, acculturation, and changes in social networks shape isolation, loneliness, and resilience among older Asian Indian immigrants.</p><p><strong>Methods: </strong>In-depth interviews were conducted with 29 Asian Indian immigrants aged 50 years and older in the Dallas-Fort Worth metroplex. Participants were recruited through purposive sampling with support from local cultural and faith-based organizations. A semi-structured interview guide examined social networks, isolation, loneliness, acculturation, cultural identity, and coping. Interviews were audio-recorded, transcribed verbatim, translated when necessary, and analyzed using inductive thematic analysis. Descriptive statistics summarized participant characteristics.</p><p><strong>Results: </strong>Participants described substantial disruption of social networks after immigration, including fewer close friendships, reduced spontaneous social interactions, and limited nearby family support. These changes contributed to loneliness and emotional strain, particularly in an individualistic social environment that contrasted with communal norms in India. Participants also described acculturative stress related to preserving Indian cultural identity while adapting to US society, especially in intergenerational family contexts. Despite these challenges, many used resilience strategies such as staying active, lifelong learning, maintaining optimism, and seeking supportive social circles.</p><p><strong>Conclusion: </strong>Social isolation among older Asian Indian immigrants reflects a public health challenge shaped by migration, cultural adaptation, family dispersion, and limited culturally relevant supports. Community-based, culturally tailored interventions are needed to strengthen social connection, reduce loneliness, and promote healthy aging in immigrant communities.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 3","pages":"e70365"},"PeriodicalIF":1.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945979","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":"Determinants of Awareness of High School and Preparatory Students About HIV/AIDS: The Case of Sayint Preparatory and General Secondary School, South Wollo, Ethiopia.","authors":"Tilahun Adugna, Solomon Gezahegn, Fitsum Tigu, Mujib Abdulkadir, Asnake Desalegn","doi":"10.1002/puh2.70357","DOIUrl":"10.1002/puh2.70357","url":null,"abstract":"<p><strong>Introduction: </strong>The human immunodeficiency virus (HIV) continued to be the major threat to the world. The Ethiopian National Plan, as well as the UNAIDS target for the year 2021-2025, is to significantly reduce the transmission, enhance the prevention and control strategies to reduce deaths from the disease.</p><p><strong>Objective: </strong>This study aimed to investigate the determinants of knowledge, attitude, and practice (KAP) towards HIV/AIDS among Sayint Preparatory and General Secondary School students.</p><p><strong>Methods: </strong>An institution-based cross-sectional study was conducted from August to September 2023. Purposive sampling was used to select the site, and simple random sampling was used to recruit study participants.</p><p><strong>Results: </strong>The majority of the respondents had good knowledge (87.3%), positive attitude (88.9%), and good practice (88.6%). From the multivariate analysis, being from an urban area (AOR = 6.52, CI: 2.22-19.12), Grade 10 (AOR, 2.70; CI: 1.15-6.36), and Grade 11 (AOR, 3.69; CI: 1.47-9.30) and (AOR, 2.41-30.27) were factors associated with the knowledge about HIV/AIDS. Being married (AOR, 3.98, CI: 1.10-14.56) and obtaining information from family members (AOR, 0.30; CI: 0.11-0.80) were variables significantly associated with attitude towards HIV/AIDS.</p><p><strong>Conclusion: </strong>The KAP of the respondents towards HIV/AIDS was high, but misconceptions were also noted. Extensive sex education programs in schools should be devised to solve the risks associated with HIV/AIDS.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 3","pages":"e70357"},"PeriodicalIF":1.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945494","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":"Predictors and Prevalence of Sugar-Sweetened Beverages Consumption Among Health Care Professionals in Tamale, Ghana.","authors":"Michael Akenteng Wiafe, Hamza Sulemana, Gabriel Libienuo Sowley Kalog, Kwadwo Densi Amankwah","doi":"10.1002/puh2.70354","DOIUrl":"10.1002/puh2.70354","url":null,"abstract":"<p><strong>Background: </strong>The study assessed the consumption of sugar-sweetened beverages (SSBs) and its associated factors among health care professionals in the Tamale Metropolis.</p><p><strong>Methods: </strong>In this cross-sectional study, 345 health care professionals were randomly recruited. A semi-structured questionnaire was used to collect data on sociodemographic, screen time and SSBs. Descriptive, chi-square and regression analyses were used in the statistical analysis.</p><p><strong>Results: </strong>About 98% of participants had ever consumed SSBs and frequently consumed were sweetened local juice (61.6%), regular soft drink (50.4%), and sweetened coffee/tea (73.6%). Nurses (OR = 11.42, <i>p</i> < 0.05, 95% CI: 2.55-51.22), pharmacists (OR = 6.08, <i>p</i> = 0.04, 95% CI: 1.07-34.58) and nutritionists (OR = 5.37, <i>p</i> = 0.04, 95% CI: 1.02-28.31) had an increased risk of sweetened local juice intake. The odds of consuming regular soft drinks (OR = 3.27, <i>p</i> < 0.05, 95% CI: 1.72-6.21) and sport and energy drink (OR = 3.61, <i>p</i> < 0.05, 95% CI: 1.40-9.32) were higher among married participants. Female participants (OR = 4.07, <i>p</i> < 0.05, 95% CI: 1.79-9.26) had higher odds of consuming sport and energy drink.</p><p><strong>Conclusion: </strong>Health care professionals showed a high consumption rate of SSBs and frequently consumed sweetened coffee/tea; however, they had even higher odds of sweetened local juice consumption.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 3","pages":"e70354"},"PeriodicalIF":1.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945934","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":"Parental Education and Children Ever Born Among Women in Bangladesh: Evidence From a Nationally Representative Survey.","authors":"Farhia Azrin, Md Muddasir Hossain Akib, Md Salek Miah, Tanzila Tamanna, Bikash Pal, Haroon Bin Murshid, Margia Yesmin","doi":"10.1002/puh2.70366","DOIUrl":"10.1002/puh2.70366","url":null,"abstract":"<p><strong>Background: </strong>Fertility is a key determinant of population growth and overall population size. Bangladesh's total fertility rate has declined from about 6.3 births per woman in the mid-1970s to 2.3 in 2022, which is around the replacement level and, by some recent estimates, slightly below it. Yet the country remains among the world's most densely populated, and population momentum will sustain growth for decades. Understanding how parental education is associated with fertility, therefore, remains crucial for population and reproductive health policy.</p><p><strong>Methods: </strong>This cross-sectional study analyzed 3839 ever-married women aged 15-49 years from the nationally representative Bangladesh Demographic and Health Survey (BDHS) 2022. The outcome was the number of children ever born (CEB). Because the counts were underdispersed, a mean-parameterized Conway-Maxwell-Poisson regression model, selected over the Poisson and generalized Poisson models by Akaike Information Criteria (AIC) and Bayesian Information Criteria (BIC), was fitted with BDHS sampling weights, adjusting for relevant sociodemographic characteristics.</p><p><strong>Results: </strong>Maternal education showed a strong, graded inverse association with CEB. Compared with women with no education, mothers with primary (incidence rate ratio [IRR]: 0.95; 95% CI: 0.91-0.99), secondary (IRR: 0.87; 95% CI: 0.83-0.91), and higher education (IRR: 0.72; 95% CI: 0.68-0.77) had significantly fewer CEB. Paternal education was similarly associated with lower fertility: Compared with fathers with no education, those with secondary (IRR: 0.94; 95% CI: 0.91-0.97) and higher education (IRR: 0.92; 95% CI: 0.88-0.97) had fewer children. Region, residence, wealth, maternal employment, religion, and desire for more children were also significantly associated with CEB.</p><p><strong>Conclusions: </strong>Parental education, particularly maternal education, is strongly and consistently associated with lower fertility in Bangladesh. Although the cross-sectional design precludes causal inference, the findings suggest that strengthening educational opportunities, expanding access to reproductive health information and family planning services, and addressing socioeconomic disparities may help consolidate Bangladesh's fertility transition.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 3","pages":"e70366"},"PeriodicalIF":1.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957521","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":"Determinants of the Number of Tetanus-Toxoid Injections Before Birth Among Pregnant Women in Somalia: A Multilevel Analysis.","authors":"Jama Mohamed, Hamse Mohamed Amoud, Ahmed Ismail Mohamed, Abdisalam Hassan Muse, Azizur Rahman, Saralees Nadarajah","doi":"10.1002/puh2.70355","DOIUrl":"10.1002/puh2.70355","url":null,"abstract":"<p><strong>Background: </strong>Maternal and neonatal tetanus remains a major public health concern in Somalia, where low immunization coverage contributes to preventable mortality. Despite global progress, Somalia continues to report suboptimal tetanus-toxoid (TT) vaccine uptake due to conflict, weak health systems, and socioeconomic barriers. This study examined multilevel factors associated with the number of TT injections before birth among Somali women.</p><p><strong>Methods: </strong>We analyzed data from the Somali Health and Demographic Survey (2020), including 4841 pregnant women aged 15-49. A mixed-effects negative binomial regression model addressed overdispersion, excess zeros, and hierarchical structure (region and residence). Model fit was assessed using Akaike (AIC) and Bayesian (BIC) information criteria.</p><p><strong>Results: </strong>Only 32.6% of women received at least one TT injection, whereas 67.4% received none. Higher TT uptake was associated with older age (IRR = 1.62; 95% CI = 1.09-2.42), higher wealth (IRR = 1.49; 95% CI = 1.01-2.18), prior vaccination (IRR = 1.76; 95% CI = 1.44-2.16), antenatal care visits (IRR = 1.02; 95% CI = 1.01-1.04), employment (IRR = 1.41; 95% CI = 1.00-1.97), clinic deliveries (IRR = 1.23; 95% CI = 1.01-1.50), and health insurance (IRR = 5.24; 95% CI = 1.04-26.47). Conversely, zero uptake was more likely among nomadic women (AOR = 1.40; 95% CI = 1.06-1.85), those with no prior vaccination (AOR = 3.64; 95% CI = 2.76-4.80), home deliveries (AOR = 1.42; 95% CI = 1.18-1.71), no phone ownership (AOR = 1.31; 95% CI = 1.02-1.68), and women whose husbands lacked education (AOR = 1.27; 95% CI = 1.02-1.58).</p><p><strong>Conclusion: </strong>TT vaccine coverage among pregnant women in Somalia remains critically low and is shaped by socioeconomic inequities, healthcare access, and household decision-making. Strengthening antenatal care integration, targeted outreach for nomadic populations, economic empowerment, health education, and expanding insurance coverage are essential to improve maternal immunization and eliminate neonatal tetanus.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 3","pages":"e70355"},"PeriodicalIF":1.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945874","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 Prevalence and Pattern of Dyslipidemia Among Maintenance Hemodialysis Patients in Selected Areas of Bangladesh: A Multicenter Cross-Sectional Study.","authors":"Marium Sultana, Tanjina Rahman, Md Ariful Islam, Md Abdul Halim","doi":"10.1002/puh2.70374","DOIUrl":"10.1002/puh2.70374","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a prevalent health problem frequently associated with diabetes, hypertension, and anemia. Cardiovascular disease (CVD), particularly atherosclerotic coronary artery disease, is highly prevalent in end-stage renal disease (ESRD), accounting for 40%-50% of deaths. Dyslipidemia, characterized by low high-density lipoprotein cholesterol (HDL-C) and elevated triglycerides (TG), is a common comorbidity in CKD and contributes to increased CVD risk.</p><p><strong>Methods: </strong>In this cross-sectional study, data from 152 CKD patients undergoing maintenance hemodialysis were collected using pretested structured questionnaires, clinical assessments, and biochemical testing. The median age of participants was 48 years, with middle-aged adults comprising 45.4% of the study population.</p><p><strong>Results: </strong>Dyslipidemia was assessed using the triglyceride-to-HDL cholesterol (TG/HDL-C) ratio and the Adult Treatment Panel III (ATP III) criteria. The overall prevalence of dyslipidemia was 78.9% according to the TG/HDL-C ratio. Dyslipidemic patients had significantly lower HDL-C (35.9 mg/dL) and higher TG (205.5 mg/dL) compared with non-dyslipidemic individuals. According to ATP III criteria, 79.1% of patients had mixed dyslipidemia, and 12.8% had atherogenic dyslipidemia. Patients with dyslipidemia also exhibited higher serum glucose and post-dialysis blood urea nitrogen (BUN) levels and were more likely to be malnourished.</p><p><strong>Conclusion: </strong>Dyslipidemia is highly prevalent among CKD patients in Bangladesh, highlighting the need for early detection and targeted lipid-lowering interventions to reduce cardiovascular risk in this population.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 3","pages":"e70374"},"PeriodicalIF":1.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957497","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 Pap Test to Treatment: Assessing Facility Level Gaps in Cervical Cancer Care in Cape Town.","authors":"Greta Sophie Neethling, Rubina Razack, Matthys Hendrik Hennie Botha","doi":"10.1002/puh2.70360","DOIUrl":"10.1002/puh2.70360","url":null,"abstract":"<p><strong>Introduction: </strong>The World Health Organization (WHO) 90‑70‑90 cervical cancer elimination targets aim for 90% human papillomavirus (HPV) vaccination rates, 70% cervical screening rates, and 90% treatment rates for women with cervical disease. Although progress has been made in vaccination and screening in South Africa, less is known about treatment coverage following abnormal screening results. We focused on adherence to colposcopy clinic referrals among women with abnormal cytology.</p><p><strong>Methods: </strong>We conducted a retrospective descriptive study of cervical cytology samples collected in 2022 from women attending 19 public healthcare facilities within a sub‑district of Cape Town. All cytology results reported as high‑grade intraepithelial lesions or invasive cervical carcinoma (HSIL+) were included. Colposcopy clinic attendance was defined as documented histological sampling within 24 months of diagnosis. Colposcopy clinic attendance rates (CCARs), test time intervals, and distance from referral hospital were calculated for each facility. Facilities were compared using percentile distributions, and distance to referral hospitals was analyzed as a potential spatial barrier.</p><p><strong>Results: </strong>Of 9,069 cervical samples, 556 (6.1%) were reported as HSIL+. Overall, 65.8% of women underwent histological sampling within 24 months. CCARs varied across facilities, ranging from 42.5% to 87.5% (mean 63.1%). Distance to referral hospitals (range 0-22 km; mean 10.8 km) showed no correlation with colposcopy clinic attendance.</p><p><strong>Conclusion: </strong>A substantial gap exists between current CCARs and the WHO treatment target. Variability among facilities, independent of geographic distance, suggests that health system factors, such as communication, recall, and referral processes, play a key role in treatment outcomes.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 3","pages":"e70360"},"PeriodicalIF":1.8,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898442","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 Preparedness and Perceived Challenges in Managing Medical Emergencies Among Dentists at Komfo Anokye Teaching Hospital, Ghana: A Cross Sectional Study.","authors":"Anabella Koteikai Kotey, Joseph Abu-Sakyi, Manuella-Krysty Asabea Siaw, John Billy Owusu Quarshie, Nana Atuahene Oti, Nana Bempong Owusu-Ankomah, Samuel Baffour-Awuah, Kwabena Opoku Owusu-Ansah, Elijah Kwegyir Johnson, Kwame Adu Okyere Boadu","doi":"10.1002/puh2.70359","DOIUrl":"10.1002/puh2.70359","url":null,"abstract":"<p><strong>Background: </strong>Medical emergencies in dental settings are uncommon but potentially life-threatening, and the response depends on practitioner training, institutional protocols and available equipment. Little has been published on these elements in Ghanaian dental services. This study described self-reported emergency encounters, training status, protocol awareness, equipment availability and perceived challenges at one tertiary facility.</p><p><strong>Methodology: </strong>A descriptive cross-sectional study was conducted at the Oral Health Directorate, Komfo Anokye Teaching Hospital, Kumasi. All 78 dentists on the roster were approached (attempted census); 62 returned completed self-administered questionnaires over 14 consecutive working days (response rate 79.5%). All variables were categorical, summarised as frequencies and percentages. Associations of rank and years of practice with formal emergency-management training status were examined using <i>χ</i> ² tests with Yates' correction and Fisher's exact test with odds ratios (ORs).</p><p><strong>Results: </strong>Percentages denote the proportion of 62 respondents reporting each multiple-response item, not the frequency of events among patients. Hypoglycaemia (87.1%) and syncope (79.0%) were most often reported as ever encountered, then asthma attack (69.4%), seizures (62.9%) and anaphylaxis (48.4%). Thirty-six (58.1%) reported formal training, 22 (35.5%) a written protocol and none an automated external defibrillator (AED). Training was reported more often by senior than junior dentists (69.2% vs. 39.1%; <i>p</i> = 0.040; OR 3.50, 95% confidence interval [CI] 1.19-10.29); the association with years of practice was borderline and test-dependent (Yates-corrected <i>p</i> = 0.052; Fisher's exact <i>p</i> = 0.039; OR 3.20, 95% CI 1.12-9.15). Commonest challenges were inadequate equipment (87.1%), lack of training (72.6%) and no clear protocol (69.4%).</p><p><strong>Conclusion: </strong>Two in five dentists reported no formal emergency-management training, most were unaware of a written protocol, and none reported access to an AED. These self-reported, single-centre findings suggest that periodic training, written protocols and verified equipment stocks merit institutional attention; confirmation in larger multi-centre studies is needed.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 3","pages":"e70359"},"PeriodicalIF":1.8,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898569","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":"Substandard and Falsified Medicines, Regulatory Capacity and Public Health: A Narrative Review With a Focus on Africa.","authors":"Ahmed Vandy, Nancy Oluwakemi Samai, Onome Thomas Abiri, Michael Lahai, Fawzi Thomas, Tamba Buffa, Sheku Mansaray, Alvin Turay, Augustus Osborne","doi":"10.1002/puh2.70356","DOIUrl":"10.1002/puh2.70356","url":null,"abstract":"<p><strong>Background: </strong>Weak medicines regulation contributes to the circulation of substandard and falsified medicines, undermining treatment outcomes, accelerating antimicrobial resistance and eroding public trust in health systems. This review synthesised evidence on regulatory structures and functions, mapped regional capacity, documented the public health consequences of regulatory failure and identified pathways toward stronger and more equitable pharmaceutical governance in Africa.</p><p><strong>Methods: </strong>This narrative review synthesised peer-reviewed and grey literature published between 2000 and 2025. Sources were identified through PubMed/MEDLINE, Scopus, Web of Science, Google Scholar and institutional reports from the World Health Organisation (WHO), World Bank, African Union Development Agency New Partnership for Africa's Development (AUDA-NEPAD) and national regulatory authorities. Studies were eligible if they addressed regulatory functions, the consequences of substandard and falsified medicines, WHO Global Benchmarking Tool (GBT) maturity assessments, regional harmonisation initiatives or policy responses. The search yielded 633 records, of which 122 underwent full‑text review, and 38 met the inclusion criteria. Evidence was organised thematically across regulatory functions, capacity gaps, pathways of harm, documented incidents and regulatory strengthening initiatives.</p><p><strong>Results: </strong>Evidence shows that regulatory weaknesses affect public health through therapeutic failure, toxicity, antimicrobial resistance, avoidable expenditure and inequitable exposure among vulnerable populations. African regulatory systems show substantial heterogeneity, with some authorities achieving the WHO GBT Maturity Level 3, whereas many remain at lower maturity levels. Recent advances include digital regulatory platforms, reliance mechanisms, regional harmonisation, WHO prequalification and the establishment of the African Medicines Agency.</p><p><strong>Conclusion: </strong>Strengthening national regulatory authorities to WHO GBT Maturity Level 3 and above requires sustained political commitment, predictable financing, legal reform, robust post‑market surveillance, accredited laboratory capacity and effective regional reliance mechanisms. Medicines regulation should be recognised as a core public health and health‑security priority, serving as a foundational investment in protecting populations and ensuring equitable access to quality‑assured medicines.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 3","pages":"e70356"},"PeriodicalIF":1.8,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876658","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 Locus of Control to Fear: How Intolerance of Uncertainty Shapes Young Arab Adults' Perceptions of Artificial Intelligence.","authors":"Georges Kerbage, Camille Akkari, Rabih Hallit, Diana Malaeb, Fouad Sakr, Mariam Dabbous, Nisma Merdad, Tabassum Rashid, Rizwana Amin, Kamel Jebreen, Btissame Zarrouq, Amthal Alhuwailah, Hanaa Ahmed Mohamed Shuwiekh, Souheil Hallit, Feten Fekih-Romdhane, Sahar Obeid","doi":"10.1002/puh2.70352","DOIUrl":"10.1002/puh2.70352","url":null,"abstract":"<p><strong>Background: </strong>This cross-sectional study examines whether intolerance of uncertainty (IU) is indirectly associated with the relationship between internal and external locus of control (LoC) and fear of autonomous robots and artificial intelligence (FARAI) in a convenience sample of Arabic-speaking adults from four Arab countries.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in July 2023, including 1849 participants with an average age of 21.37 years, of whom 74.3% were females. Data were collected using a distributed Google Form link.</p><p><strong>Results: </strong>The results indicated that prospective anxiety was indirectly associated with the relationship between internal LoC and fear of AI. A greater internal LoC was associated with increased prospective anxiety, which, in turn, was strongly correlated with greater FARAI scores. Internal LoC was not directly related to FARAI scores. Similarly, inhibitory anxiety was indirectly associated with the relationship between internal LoC and FARAI. Greater internal LoC strongly correlated with lower inhibitory anxiety, whereas greater inhibitory anxiety strongly correlated with greater FARAI scores. Again, no direct relationship was found between internal LoC and FARAI scores. Inhibitory anxiety was indirectly associated with the relationship between external LoC and FARAI; greater external LoC correlated with greater inhibitory anxiety, which was correlated with greater FARAI scores. External LoC was not directly related to FARAI scores.</p><p><strong>Conclusion: </strong>IU, through both prospective and inhibitory anxiety, was indirectly associated with the relation between LoC and FARAI. Because the design was cross-sectional, these findings represent associations rather than causal effects, and several of the indirect associations were small in magnitude. Tackling these forms of anxiety in young adults could be one avenue worth exploring for managing AI-related fears.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 3","pages":"e70352"},"PeriodicalIF":1.8,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13484895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802712","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}