Public health challenges最新文献

{"title":"Colliding Wars: A Systematic Review on HIV Responses in Conflict-Affected Settings.","authors":"Mona Ibrahim, Alhadi Khogali, Eslam Sadeldin, Ethar Abosam, Yejide Okungbaye, Esther Osime, Mohammed F Adam, Mohamed Elsheikh, Bothaina Eltigani, Janina Jochim, Maysoon Dahab, Rachel Yates, Lucie Cluver","doi":"10.1002/puh2.70236","DOIUrl":"10.1002/puh2.70236","url":null,"abstract":"<p><strong>Background: </strong>Armed conflicts are an escalating threat to public health, often marked by violence, poverty, displacement and weakened health systems-conditions that mirror the drivers of HIV transmission.</p><p><strong>Aim: </strong>This review examines how armed conflict is associated with HIV vulnerability, disruptions to HIV services and how service delivery has adapted in these settings.</p><p><strong>Methods: </strong>A systematic search of six databases (MEDLINE, Embase, Scopus, CENTRAL, OVID, CINAHL) was conducted up to June 2022. Six reviewers independently screened studies, resolving discrepancies through consensus.</p><p><strong>Results: </strong>Of 7378 records, 17 met inclusion criteria. Studies revealed heightened HIV risk among adolescent girls, young women and displaced populations. Service interruptions-due to looting, supply chain breakdowns and population movement-led to treatment gaps and increased loss-to-follow-up. Adolescent girls, refugees, and those living in temporary shelters experienced consistently worse HIV risks and outcomes. Despite broad search terms, there was little-to-no evidence on some key populations, including prisoners, sex workers and people who inject drugs. Adaptive HIV prevention and response strategies-including hybrid delivery models, integrated medical supply chains and runaway bags (emergency stock packs)-were reported as promising but under-documented approaches.</p><p><strong>Conclusions: </strong>Conflict-driven displacement and health system disruption are associated with heightened HIV vulnerability in some settings though effects vary by context. People living with HIV in conflict-affected areas face disproportionate risks and must be prioritized within humanitarian response plans and in host-country health systems.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 ","pages":"e70236"},"PeriodicalIF":1.8,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791682","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":"Integrating One Health Into Health Systems: A Systematic Review and Narrative Synthesis of Implementation Challenges, Opportunities and Strategic Directions.","authors":"Md Shahidul Islam, Nusrat Jahan, Daniel Teshome Gebeyehu","doi":"10.1002/puh2.70260","DOIUrl":"10.1002/puh2.70260","url":null,"abstract":"<p><strong>Background: </strong>The One Health (OH) approach, which gained international prominence in the early 2000s and was formally articulated through a unified definition in 2022, promotes coordinated action across human, animal and environmental health sectors. Despite increasing global recognition, its integration into national health systems remains inconsistent. This review synthesizes global evidence on challenges, opportunities and strategic directions for embedding OH within health system structures.</p><p><strong>Study design: </strong>A systematic review with narrative synthesis.</p><p><strong>Methods: </strong>This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Peer-reviewed studies published between 1 June 2013, and 1 April 2025 were identified through searches conducted in January-February 2025 in Scopus, PubMed, Web of Science and ProQuest Health and Medicine. Supplementary searches included Google Scholar and backward reference screening. Two reviewers independently screened studies and applied predefined eligibility criteria. Findings were synthesized narratively.</p><p><strong>Results: </strong>Of 2606 records identified, 17 studies were included. The studies represented Africa, Europe, Asia, Australia and multi-country settings across varying income levels. Key challenges included weak governance arrangements, limited legal and policy support, inadequate financing, workforce capacity constraints and persistent sectoral fragmentation. Opportunities were linked to heightened awareness of zoonotic threats and antimicrobial resistance, growing institutional endorsement, academic engagement and emerging multisectoral coordination mechanisms.</p><p><strong>Conclusion: </strong>Sustainable integration of OH requires embedding it within governance, financing and service delivery systems rather than implementing it as parallel initiatives.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 ","pages":"e70260"},"PeriodicalIF":1.8,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791736","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":"Maternal Prenatal Supplements Intake and Dietary Sources and Their Relation to Autism Spectrum Disorder in the Population of Bangladesh.","authors":"Md Shahid Khan, Mohammad Alamgir Kabir, Shafi Mohammad Tareq","doi":"10.1002/puh2.70253","DOIUrl":"10.1002/puh2.70253","url":null,"abstract":"<p><p>Studies on maternal prenatal supplements intake and sources of dietary factors related to the risk of autism spectrum disorder (ASD) are in their infancy, especially in developing countries like Bangladesh. An observational case-control study in Bangladesh delved into the potential connections between prenatal nutrition and the likelihood of ASD. Parents of 310 ASD cases and 310 healthy controls (HCs) participated, sharing insights through structured questionnaires and face-to-face interviews. This study focused on associations with significant levels at <i>p</i> ≤ 0.05, employing odds ratios (ORs) and 95% confidence intervals (CIs) to pinpoint potential risk factors. The findings offer intriguing insights as follows: consuming prenatal supplements, farmed chicken or eggs, and farmed vegetables during pregnancy and the first 3 years of life emerged as associated with a reduced likelihood of ASD compared to HCs. Interestingly, the opposite trend was observed for farmed fish and fruits during the same period, alongside maternal substance or drug misuse during pregnancy, which was linked to increased ASD odds. Additionally, higher parental socioeconomic status during pregnancy appeared to have a protective effect, whereas the male gender emerged as a significant risk factor. Considering the substantial public health and economic burden of ASD, these findings highlight potential avenues for intervention. Encouraging responsible prenatal supplement intake, discouraging maternal substance or drug misuse, and ensuring the safety of farmed fish, chicken or eggs, fruits and vegetables during pregnancy and early childhood may offer valuable tools for potentially reducing ASD risk.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 ","pages":"e70253"},"PeriodicalIF":1.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791671","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":"Sex Differences in the Factors Associated With Lifetime Alcohol, Tobacco and Cannabis Use Among Ghanaian University Students: A Cross-Sectional Study.","authors":"Yula Salifu, Joseph Lasong, Amidu Alhassan, Frank Offei Odonkor, Torjim Salifu","doi":"10.1002/puh2.70250","DOIUrl":"10.1002/puh2.70250","url":null,"abstract":"<p><strong>Background: </strong>Substance use among university students in Ghana is a pressing concern, with pronounced sex differences yet poorly characterised determinants. This study examined factors associated with lifetime alcohol, tobacco and cannabis use among undergraduate students, with explicit attention to sex-specific patterns.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from January to March 2023 at the University for Development Studies, Tamale. A total of 600 undergraduate students were recruited using quota sampling proportional to school, year and sex, followed by simple random selection (response rate 100%). Lifetime use was defined as self-reported use of each substance at least once, measured using an adapted World Health Organization (WHO) Student Drug Use Survey. Sex-stratified modified Poisson regression with robust standard errors estimated prevalence rate ratios (aPRRs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Lifetime prevalence was 17.7% for alcohol, 17.0% for tobacco and 16.7% for cannabis. Males reported higher use across all substances (alcohol: 31.1%; tobacco: 30.6%; cannabis: 27.4%) than females (11.3%, 10.6%, 11.6%). In the total sample, male sex (aPRR 2.01), older age (>24 years) (1.85) and peer or family drug history (1.41-1.48) predicted higher alcohol use, whereas Islamic faith (0.59) and residing at a friend's house (0.49) were protective. Male sex (3.12) and non-Christian religion (3.28) predicted tobacco use. Male sex (2.56) was the only pooled predictor of cannabis use. Sex-stratified analyses revealed distinct patterns: strict parental supervision and absence of family conflict protected males against alcohol use; Islamic faith protected females; residential autonomy and persistent family conflict were female-specific cannabis risk factors.</p><p><strong>Conclusions: </strong>Sex differences profoundly shape substance use among university students in Ghana. Religion, parental oversight and family dynamics are key protective or risk factors that differ by sex. Prevention strategies must be sex-sensitive and culturally grounded.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 ","pages":"e70250"},"PeriodicalIF":1.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791597","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 and Predictors of Adolescent Tobacco Use in the Russian Federation: Insights From a Nationwide Survey.","authors":"Ashfaq Ahmad Shah Bukhari, Syed Sikandar Shah, Mouhammed Sleiay, Mahmoud M Ali","doi":"10.1002/puh2.70254","DOIUrl":"10.1002/puh2.70254","url":null,"abstract":"<p><strong>Background: </strong>Tobacco use is a leading cause of preventable disease and death worldwide. In Russia, despite tobacco-control measures, adolescent tobacco use remains a significant public health concern.</p><p><strong>Objective: </strong>This study aimed to assess the prevalence and predictors of tobacco use among adolescents aged 13-15 years in the Russian Federation using data from the Global Youth Tobacco Survey (GYTS).</p><p><strong>Methods: </strong>The present study was a cross-sectional study based on secondary analysis of data from the 2021 Russian Federation GYTS. Descriptive statistics, bivariate analysis, and multivariable logistic regression were used to evaluate sociodemographic and attitudinal factors associated with adolescent tobacco use.</p><p><strong>Results: </strong>The findings showed that the prevalence of adolescent tobacco use was 16.3% among 13-year-olds, to 21.4% among 14-year-olds, and 29.6% among 15-year-olds (<i>p</i> < 0.001). Male adolescents had a higher prevalence of tobacco use than females (22.7% vs. 20.8%, <i>p</i> = 0.009). Tobacco use prevalence also increased by school level, reaching 29.0% among ninth-grade students, compared with 17.2% and 20.7% among seventh- and eighth-grade students, respectively (<i>p</i> < 0.001). Weekly spending was strongly associated with tobacco use, with prevalence rising to 36.0% among adolescents spending 1000 rubles or more per week. In multivariable analysis, adolescents spending 1000 rubles or more per week had over twice the odds of tobacco use (adjusted odds ratio [OR]: 2.03; 95% confidence interval [CI]: 1.75-2.46; <i>p</i> < 0.001). Positive tobacco use expectancies were also strongly associated with tobacco use, with adjusted ORs reaching 10.79 among adolescents who agreed that they might enjoy tobacco use.</p><p><strong>Conclusions: </strong>The findings of this study highlight that adolescent tobacco use in Russia continues to be a significant public health issue, characterized by an increasing prevalence with age, an emergence of a relatively small sex difference in prevalence, and strong associations with socioeconomic factors and positive tobacco use expectancies.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 ","pages":"e70254"},"PeriodicalIF":1.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13117212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791467","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":"Understanding Barriers to Cancer Pain Management: Insights From Patients and Healthcare Professionals-A Systematic Review.","authors":"Belete Muluadam Admassie, Amanuel Sisay Endeshaw, Kumlachew Geta Belete, Diriba Teshome, Basazinew Chekol Demilew, Amare Belete Getahun, Misganew Terefe Molla, Tikuneh Yetneberk Alemayehu, Abebe Tiruneh Boled, Efrem Fenta Alemnew, Getachew Mekete Diress, Biruk Adie Admass","doi":"10.1002/puh2.70247","DOIUrl":"10.1002/puh2.70247","url":null,"abstract":"<p><strong>Background: </strong>Cancer-related pain is a prevalent and debilitating symptom that significantly impairs patients' quality of life, leading to physical discomfort as well as emotional and psychological distress. Despite the availability of effective pain control strategies, cancer pain remains inadequately managed worldwide. This challenge is multifactorial, involving barriers related to patients, healthcare providers, healthcare systems, and deficiencies in coordinated multidisciplinary care.</p><p><strong>Methods: </strong>This systematic review followed the PRISMA 2020 guidelines and was registered with PROSPERO (CRD420251027582). A comprehensive search of SCOPUS, PubMed, MEDLINE, EMBASE, ScienceDirect, the Cochrane Library, and Google Scholar was conducted for studies published between 2015 and 2025. Qualitative, quantitative, and mixed-methods studies examining barriers to cancer pain management from patient and healthcare professional perspectives were included. Study quality was assessed using the Newcastle-Ottawa Scale, and findings were synthesized narratively.</p><p><strong>Results: </strong>A total of 244 records were identified, with 23 studies meeting the inclusion criteria after screening and eligibility assessment. Overall methodological quality was good, although most studies were cross-sectional. Four major categories of barriers were identified: patient-related, healthcare provider-related, healthcare system-related, and multidisciplinary care-related barriers. Patient-related barriers were most frequently reported fear of opioid addiction, concerns about side effects, under-reporting of pain, fatalistic beliefs, and cultural or religious influences. Provider-related barriers involved inadequate training, poor pain assessment practices, opioid-related concerns, and limited inter-professional communication. System-level barriers included restrictive opioid regulations, limited access to analgesics, staffing shortages, and lack of standardized protocols. Multidisciplinary barriers reflected poor care coordination, insufficient patient education, and lack of individualized pain management plans.</p><p><strong>Conclusion: </strong>Cancer pain management is hindered by interconnected barriers across patient, provider, and system levels. Addressing these challenges requires improved clinical practices, targeted professional education, balanced opioid policies, and strengthened multidisciplinary collaboration to enhance patient outcomes and quality of life.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 ","pages":"e70247"},"PeriodicalIF":1.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791651","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":"Pharmaceutical Wastage in Public Health Facilities of Ethiopia: Determinants, Consequences, and Solutions.","authors":"Ewunetie Mekashaw Bayked, Adam Tesfaw Debeb, Getachew Moges, Husien Nurahmed Toleha, Teklehaimanot Fentie Wendie, Minimize Hassen","doi":"10.1002/puh2.70244","DOIUrl":"10.1002/puh2.70244","url":null,"abstract":"<p><strong>Background: </strong>Pharmaceutical wastage presents a significant challenge to health systems in developing countries, including Ethiopia; however, evidence regarding its magnitude and drivers remains limited. This study aimed to examine the extent of pharmaceutical wastage in public health facilities in Northwest Ethiopia, identify its key determinants and consequences, and explore feasible solutions to minimize losses and improve pharmaceutical efficiency. Unlike previous single-method studies, this research integrates financial quantification with a qualitative exploration of systemic issues, thereby providing a comprehensive evidence base to inform policy and supply chain reforms.</p><p><strong>Methods: </strong>An explanatory-sequential mixed-methods design was employed in 17 public health facilities. A cross-sectional survey of 121 health professionals, selected through stratified random sampling, quantified wastage and perceptions using self-administered questionnaires. Descriptive statistics (MS Excel 2016, Statistical Package for the Social Sciences [SPSS] v26) were applied. In-depth interviews with purposively selected key informants provided qualitative insights, thematically analyzed using QDA Miner Lite v2.0.9.</p><p><strong>Results: </strong>The total value of wasted pharmaceuticals was ETB 12,201,119.21 (approximately $235,089.00), calculated using the average 2022 exchange rate of $1 = 51.9 ETB, resulting in an overall wastage rate of 4.0%. A decline was observed from 4.72% in 2012 to 2.96% in the 2014 Ethiopian fiscal year. Expired products accounted for nearly 98% of the wastage value. Health professionals identified lack of accountability, receipt of near-expiry products, and absence of inter-facility transfer mechanisms as major causes. Key informants further highlighted facility, supplier, and system-level weaknesses as contributing factors.</p><p><strong>Conclusion: </strong>Although wastage rates showed a declining trend, levels remain above the national standard, with expiration the leading cause. Strengthening accountability, introducing electronic inventory systems, and enabling redistribution of near-expired products between facilities are essential to minimize losses and improve efficiency in resource-limited health systems.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 ","pages":"e70244"},"PeriodicalIF":1.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791478","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":"Assessment of Venous Thromboembolism Risk Among Patients Admitted to Intensive Care Units in Dhaka City: A Cross-Sectional Study.","authors":"Md Shek Sady Khan, Md Maruf Parves, Abdullah Al Noman, Pradip Kumar Sen Gupta, Md Mojibur Rahman, Kazi Fharia Tanjim, Masuma Khatun, Muhammad Jubaer Chowdhury, Kazi Ashiqur Rahman, A K M Ferdous Rahman, Md Sadekul Islam","doi":"10.1002/puh2.70257","DOIUrl":"10.1002/puh2.70257","url":null,"abstract":"<p><strong>Background: </strong>Despite recognized evidence that venous thromboembolism (VTE) is a common and preventable complication in critically ill patients with pulmonary embolism as the most preventable cause of in-hospital death, we assessed VTE risk and prophylaxis use in ICU patients from Dhaka City.</p><p><strong>Methods: </strong>This cross-sectional study was conducted from January to June 2018 in two tertiary care hospitals of Dhaka. We prospectively included 130 patients with ICU admission for ≥24 h. The Padua risk assessment model (RAM) was used to assess VTE risk and patients with a score of ≥4 were classified as high risk. Chi-square tests and Student's <i>t</i>-tests were used for statistical analysis.</p><p><strong>Results: </strong>High-risk status was significantly associated with advancing age and specific clinical predictors. Strong predictors for high-risk status included thrombophilia, immobilization and active malignancy. Despite high-risk status, only 28.57% received prophylaxis. Clinicians preferentially administered prophylaxis to elderly patients and those with acute infections, while overlooking predictors like malignancy. The overall in-hospital mortality was 15.4%.</p><p><strong>Conclusion: </strong>Nearly half of ICU patients are at high risk for VTE, yet prophylaxis utilization remains inadequate. Systematic implementation of mandatory risk assessment protocols is essential to bridge this clinical gap.</p><p><strong>Clinical trial registration: </strong>This study is a cross-sectional observational study involving no experimental intervention, treatment allocation or clinical trial procedures. Accordingly, clinical trial registration was not required or applicable for this study design.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 ","pages":"e70257"},"PeriodicalIF":1.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13117206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791632","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":"Child Brides in Africa: A Narrative Review on Effects, Gaps, and Interventions.","authors":"Olaoye Damilola Quazeem, Onaho Pascal Oghenekaro, Durojaye Aishat Bisoye, Okoro Chidinma Peace, Akindele Folasade Diana, Aina Jesutosin Oluwadara, Dibia Ermesto Oluwafemi","doi":"10.1002/puh2.70217","DOIUrl":"10.1002/puh2.70217","url":null,"abstract":"<p><p>Child marriage, defined as the union of a child under 18 years with an adult or another child, remains a pervasive issue globally, particularly in sub-Saharan Africa. Despite international efforts to eradicate this practice, approximately 15 million girls marry before 18 annually, infringing on their basic human rights and leading to severe health, educational, and social consequences. This narrative review focuses on the high prevalence and complex causes of child marriage in sub-Saharan Africa, especially in Nigeria, Mali, Guinea, Chad, and Niger, where cultural, economic, and societal factors sustain this harmful practice. Using databases such as Medline, PubMed, PubMed Central, and Google Scholar, alongside grey literature, to understand the prevalence, causes, and impacts of child marriage in Africa, findings highlight that child marriage leads to significant health risks, including increased maternal and infant mortality, mental health issues, and limited educational and economic opportunities for young girls. The review also examines various interventions, including legal reforms, educational programs, economic incentives, and health initiatives, that have been implemented to address this issue. Successful case studies from Ethiopia and Nigeria illustrate the potential of targeted interventions to reduce the prevalence of child marriage and improve the lives of young girls. The study underscores the urgent need for comprehensive strategies that address the root causes of child marriage and promote gender equality. Recommendations include strengthening legal frameworks, increasing access to education and economic opportunities for girls, and enhancing community awareness and engagement to shift cultural norms. By highlighting the multifaceted nature of child marriage and showcasing effective intervention programs, this research aims to inform policymakers, stakeholders, and communities about the critical need to eradicate this practice and safeguard the rights and well-being of young African girls.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 ","pages":"e70217"},"PeriodicalIF":1.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791652","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 and Predisposing Factors of <i>Helicobacter pylori</i> Infection in Symptomatic Patients: A Multicenter Study in Ghana's Upper East Region.","authors":"Elvis Ramsy Awuni, Maxwell Akonde, Benedict Boateng Antuamwine","doi":"10.1002/puh2.70248","DOIUrl":"10.1002/puh2.70248","url":null,"abstract":"<p><strong>Background: </strong><i>Helicobacter pylori</i> (<i>H. pylori</i>) infection is a major cause of dyspeptic disorders and remains highly prevalent in Ghana. However, data on its epidemiology in northern Ghana are limited. The aim of the study was to determine the prevalence of <i>H. pylori</i> infection and identify associated predisposing factors among dyspeptic patients in the Upper East Region of northern Ghana.</p><p><strong>Methods: </strong>A multicenter cross-sectional study was conducted among 325 dyspeptic patients tested for <i>H. pylori</i> infection. Sociodemographic and clinical data were collected using a structured questionnaire, whereas stool samples were analyzed for <i>H. pylori</i> antigens using an immunoassay. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with <i>H. pylori</i> infection.</p><p><strong>Results: </strong>The overall prevalence of <i>H. pylori</i> infection was 65.8% (214/325), with the highest prevalence observed in patients within the age category 1-20 years (40.7%). Major predisposing factors included use of public toilets (57.0%), consumption of untreated water (66.4%), and rural residence (56.5%). Consumption of food from street vendors was associated with a 2.27-fold increased likelihood of infection (odds ratio [OR] = 2.27), whereas intake of fresh fruits and vegetables increased the risk by 4.81-fold (OR = 4.81). Patients from larger households (≥13 members) were at greater risk of infection compared with those from smaller households (1-6 members) (OR = 0.31).</p><p><strong>Conclusion: </strong>The study reveals a high prevalence of <i>H. pylori</i> infection in Ghana's Upper East Region, which is strongly associated with poor sanitation and inadequate personal and food hygiene. Public health interventions aimed at improving sanitation, water quality, food safety, and living conditions are crucial for reducing transmission.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 ","pages":"e70248"},"PeriodicalIF":1.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791457","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}