BMC Public Health最新文献

{"title":"Relationship between sustainable food literacy, organic food consumption and climate change awareness and worry in Türkiye.","authors":"Özge Mengi Çelik, Sena Dilşad Akçakaya, Emine Merve Ekici","doi":"10.1186/s12889-025-22482-0","DOIUrl":"10.1186/s12889-025-22482-0","url":null,"abstract":"<p><strong>Objective: </strong>The rapid increase in population, industrialization, and the rise in fossil fuel consumption have led to issues such as the depletion of natural resources, loss of biodiversity, and climate change, bringing the concept of sustainability to the forefront. This study aimed to examine the relationship between sustainable food literacy, organic food consumption, climate change awareness and worry.</p><p><strong>Methods: </strong>This cross-sectional study included 1660 adults aged 18-65 years. Data were collected via a web-based survey that included demographic information, self-reported anthropometric measurements, and validated scales: Climate Change Awareness Scale, Climate Change Worry Scale, Organic Food Consumption Scale, and Sustainable Food Literacy Scale.</p><p><strong>Results: </strong>The mean age of the participants was 29.3 ± 12.07 years. A strong positive relationship was observed between the total score of the Climate Change Awareness Scale and the scores of the Climate Change Worry Scale, Organic Food Consumption Scale, and Sustainable Food Literacy Scale (r = 0.230, p < 0.001; r = 0.149, p < 0.001; r = 0.173, p < 0.001, respectively). According to linear regression analysis, it was determined that gender, education level, Climate Change Awareness Scale total score, Climate Change Worry Scale score, and Sustainable Food Literacy Scale score were correlated with the Organic Food Consumption Scale score (R²=0.527; p < 0.001). On the other hand, it was determined that gender, education level, income status, Climate Change Awareness Scale total score, Climate Change Anxiety Scale score and Organic Food Consumption Scale score were correlated with the Sustainable Food Literacy Scale score (R²=0.505; p < 0.001). It was determined that Climate Change Anxiety Scale score and the Sustainable Food Literacy Scale score were associated with the Climate Change Awareness Scale total score (R²=0.246; p < 0.001). In addition, it was determined that gender, marital status, Climate Change Awareness Scale total score, and Sustainable Food Literacy Scale score were associated with the Climate Change Worry Scale score (R²=0.286; p < 0.001).</p><p><strong>Conclusions: </strong>As a result, to combat global climate change, it is necessary to conduct further research in this field by considering these relationships, to identify and improve the factors influencing sustainable behaviors, to promote organic food consumption, and to assess awareness and anxiety regarding climate change.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2491"},"PeriodicalIF":3.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unhealthy food consumption and its determinants among children aged 6-23 months in Bangladesh: insights from the Demographic and Health Survey 2022.","authors":"Rafid Hassan, Md Shahadoth Hossain, Md Jarif Mahbub, Md Ruhul Amin, Sanjib Saha","doi":"10.1186/s12889-025-23668-2","DOIUrl":"10.1186/s12889-025-23668-2","url":null,"abstract":"<p><strong>Background: </strong>Low- and middle-income countries (LMICs), including Bangladesh, are experiencing a nutritional transition characterized by rising unhealthy food consumption (UFC), which increases the risk of nutrient deficiencies and chronic diseases in children. Despite this concern, research on UFC among Bangladeshi children aged 6-23 months is limited. Therefore, this study aims to estimate the prevalence and identify the factors contributing to UFC in this age group.</p><p><strong>Methods: </strong>This study analyzed the Bangladesh Demographic and Health Survey (BDHS) 2022 dataset, including 2,499 children aged 6-23 months. UFC was defined as the consumption of sweetened beverages or sentinel unhealthy foods within the past 24 hours. Multivariate logistic regression was used to identify factors associated with UFC.</p><p><strong>Results: </strong>The prevalence of UFC among children was 61.8%, with 49.2% consuming sentinel unhealthy foods and 31.4% consuming sweetened beverages. The strongest predictor of UFC was older child aged 18-23 months (AOR: 3.31, 95% CI: 2.55-4.32), and consuming minimum diversified diet (AOR: 2.50, 95% CI: 1.98-3.15). Other significant factors included recent morbidity (AOR: 1.24, 95% CI: 1.01-1.53), maternal employment (AOR: 1.36, 95% CI: 1.04-1.77), media exposure (AOR: 1.28, 95% CI: 1.02-1.59), and lower paternal education [primary (AOR: 1.72, 95% CI: 1.21-2.44); secondary (AOR: 1.58, 95% CI: 1.14-2.18)]. However, maternal decision-making power (AOR: 0.75, 95% CI: 0.58-0.96) and intended pregnancies (AOR: 0.76, 95% CI: 0.59-0.97) were associated with lower odds of UFC. Regional disparities were observed, with higher UFC prevalence in Dhaka, Khulna, Mymensingh, Rajshahi, and Rangpur.</p><p><strong>Conclusion: </strong>The study highlights Bangladeshi children's high prevalence of UFC, which demands public health interventions together with integrating behavior change communication into health, community and family-level services.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2498"},"PeriodicalIF":3.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The development and validation of the irrational beliefs scale for people living with HIV.","authors":"LongSheng Xie, Min Tian, Wei Wei, JianLan Ren, YuBei Liu, ZhaoLan Yu, YanHua Chen","doi":"10.1186/s12889-025-23611-5","DOIUrl":"10.1186/s12889-025-23611-5","url":null,"abstract":"<p><strong>Objective: </strong>To develop a culturally adapted scale measuring HIV-related irrational beliefs among PLHIV in China, and to examine its psychometric properties.</p><p><strong>Methods: </strong>The study was conducted from 05/2022 to 11/2023 with four stages. Stage 1: a pool of items was constructed through semi-structured interviews with 48 PLHIV; Stage 2: 14 multidisciplinary experts were invited to evaluate the content validity of the scale; Stage 3: the test-retest reliability of the scale was conducted with 31 PLHIV; and Stage 4: a convenience sampling was used to conduct an online and on-site survey of PLHIV in eight designated institutions of antiretroviral treatment in Luzhou and Anyue regions.</p><p><strong>Results: </strong>Finally, a pool of 45 items was formed, with a Scale-level Content Validity Index average was 0.97 and the content validity index for each item was 0.86-1. The intra-class correlation coefficient for test-retest reliability was 0.845. After exploratory factor analysis, four factors were extracted: Self-related Irrational Beliefs (SRIBs); Disease-related Irrational Beliefs (DRIBs); Treatment-related Irrational Beliefs (TRIBs), and Privacy-related Irrational Beliefs (PRIBs), with a total of 35 items, which could explain 60.6% variance. The Cronbach's α of the Irrational Beliefs Scale of PLHIV was 0.951, and the Cronbach's α of each dimension ranged from 0.851 to 0.928.</p><p><strong>Conclusion: </strong>The scale could be used as a valid tool for measuring irrational beliefs among PLHIV.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2494"},"PeriodicalIF":3.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12272983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using time use diaries to assess physical activity and sedentary behavior in jail populations.","authors":"Ricky Camplain, Sara Shuman, Adrienne Alonso, Elizabeth Schmitter, Javier Lopez, Amy Gelatt, Rebecca Annorbah, Isabel Fangman, Morgan Occhino, Brooke de Heer, Dirk de Heer, Meredith Brown, Kate Compton-Gore, Travis Pinn, Beya Thayer, Richard Martin, Linnea Evans","doi":"10.1186/s12889-025-23706-z","DOIUrl":"10.1186/s12889-025-23706-z","url":null,"abstract":"<p><strong>Background: </strong>People incarcerated have limited access to physical activity and there are challenges to accurately measure their physical activity in jail settings. We aimed to (1) determine the feasibility of time use diaries to measure physical activity and sedentary time among people incarcerated in jail and (2) estimate time spent in physical activity and sedentary behaviors, overall and by gender and job assignment.</p><p><strong>Methods: </strong>In July 2023, we recruited women and men from two housing units at Yavapai County Detention Facility, a county jail in Camp Verde, Arizona. Participants were asked to complete a four-day time use diary, documenting activities in 10-minute increments. Participants provided feedback about the diary during listening sessions after the four-day period. Feasibility was measured as the proportion of people recruited who participated and the proportion of completed and returned diaries. Activities documented in the diaries were linked to the Compendium of Physical Activities to determine intensity and duration of physical activity and sedentary behavior. Average daily time spent in physical activity and sedentary behavior was calculated for each participant.</p><p><strong>Results: </strong>Of the 24 women and 41 men recruited, 24 (100%) women and 40 (97.5%) men agreed to participate in the study. All diaries were returned. Most (82.8%) participants completed all four days in the diary. Participants were enthusiastic about filling out the diaries because they helped pass the time and felt the work would further knowledge and wellbeing in jails. Participants made concrete recommendations including altering the diary format to allow for additional detail about their time in jail. Participants spent on average 571 minutes sedentary, 79 minutes in light activity, and 60 minutes in moderate activity per day. Women spent 66 more minutes per day engaged in light activities compared to men. Women with job assignments spent 179 less minutes in sedentary behavior and 245 more minutes in moderate activity compared to women who did not have a job assignment.</p><p><strong>Conclusions: </strong>Time use diaries are a feasible and appropriate way to measure physical activity and sedentary behavior among people incarcerated in jail.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2503"},"PeriodicalIF":3.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pooled prevalence of anaemia and its associated factors among adolescent girls in East and West Africa: a systematic review and meta-analysis.","authors":"Daniel Gashaneh Belay, Baye Tsegaye Amlak, Dagmawi Chilot, Adugnaw Zeleke Alem, Mehari Woldemariam Merid","doi":"10.1186/s12889-025-23701-4","DOIUrl":"10.1186/s12889-025-23701-4","url":null,"abstract":"<p><strong>Introduction: </strong>Anemia is a major public health issue that significantly affects health, as well as social and economic development worldwide. Among adolescent girls, the prevalence of anemia is higher due to increased demands for blood volume expansion associated with the onset of menstruation and the rapid growth during adolescence. Therefore, this systematic review and meta-analysis was conducted to estimate the pooled prevalence of anemia and its associated factors among adolescent girls in East and West African countries.</p><p><strong>Methods: </strong>All published and unpublished studies from East and West Africa available in PubMed, the Cochrane Library, Hinari, and Google Scholar were screened based on their titles, abstracts, study design, and full-text review before inclusion in the meta-analysis. Data were extracted after assessing the quality of evidence using the Joanna Briggs Institute (JBI) critical appraisal tool for cross-sectional studies. Microsoft Excel was used for data extraction, and STATA version 14 was employed for statistical analysis. A forest plot was used to display the pooled prevalence of anemia among adolescent girls in East and West Africa. Heterogeneity was assessed using random-effects models, subgroup analysis, meta-regression, and sensitivity analysis. Publication bias was evaluated using Egger's regression test and funnel plot analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to present the factors associated with anemia among adolescent girls.</p><p><strong>Results: </strong>A total of twenty-nine studies involving 12,905 participants were included in the analysis. The pooled prevalence of anemia among adolescent girls was 32.88% [95% CI: 24.62%, 41.14%], based on a random-effects model. The meta-analysis also identified significant associations between anemia and certain factors. Adolescent girls living in rural areas were more likely to have anemia compared to those in urban areas (OR = 4.19; 95% CI: 1.42, 12.41; I² = 76.2%, p = 0.006). Additionally, girls who had not heard about anemia had significantly higher odds of being anemic (OR = 12.25; 95% CI: 4.59, 32.64; I² = 81.1%, p < 0.01).</p><p><strong>Conclusion: </strong>The pooled prevalence of anemia among adolescent girls in East and West African countries represents a moderate public health concern. Adolescent girls living in rural areas and those who had not heard about anemia were significantly more likely to develop the condition. Addressing this nutritional challenge requires strong intersectoral collaboration between the health and education sectors to promote awareness, prevention, and effective interventions targeting adolescent girls.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2482"},"PeriodicalIF":3.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Productive aging patterns and associations with health outcomes among Chinese urban older adults.","authors":"Zexi Su","doi":"10.1186/s12889-025-23688-y","DOIUrl":"10.1186/s12889-025-23688-y","url":null,"abstract":"","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2487"},"PeriodicalIF":3.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Understanding non‑partner sexual violence perpetration in young Tanzanian men: a cross‑sectional study.","authors":"Rebecca Brambilla, Gerry Mshana, Neema Mosha, Andrew Gibbs, Donati Malibwa, Saidi Kapiga, Heidi Stöckl","doi":"10.1186/s12889-025-23782-1","DOIUrl":"10.1186/s12889-025-23782-1","url":null,"abstract":"","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2490"},"PeriodicalIF":3.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12272979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decomposing socioeconomic and educational inequalities in infant mortality in Sub-Saharan Africa: DHS insights linked to countdown to 2030 and agenda 2063.","authors":"Rahel Mulatie Anteneh, Zekaryas Ewnetu Gashu, Lemlem Daniel Baffa, Desalegn Anmut Bitew, Chalachew Yenew, Kaleb Assegid Demissie, Bewuketu Terefe, Melak Jejaw, Alebachew Ferede Zegeye, Misganaw Guadie Tiruneh, Tadesse Tarik Tamir, Tadele Biresaw Belachew, Wubshet Debebe Negash, Elsa Awoke Fentie, Desale Bihonegn Asmamaw","doi":"10.1186/s12889-025-23683-3","DOIUrl":"10.1186/s12889-025-23683-3","url":null,"abstract":"<p><strong>Introduction: </strong>Infant mortality, defined as the death of a baby within its first year of life, remains a critical public health issue, particularly in Sub-Saharan Africa (SSA). Health equity is a fundamental right, yet significant disparities persist, with poorer populations experiencing disproportionately higher mortality rates. This study aims to assess whether these inequalities in infant mortality continue despite governmental efforts and the pursuit of Sustainable Development Goals (SDGs) in SSA countries.</p><p><strong>Methods: </strong>We analyzed a comprehensive dataset comprising 30,109 weighted samples from Demographic and Health Surveys across 14 SSA countries. Data cleaning was performed using Microsoft Excel, and statistical analyses were conducted with STATA Version 17 software. To evaluate wealth-related inequalities in infant mortality, we employed the concentration index and curve, alongside Wag staff decomposition analysis. A p-value of < 0.05 was considered statistically significant.</p><p><strong>Result: </strong>The pooled estimate of the infant mortality rate in Sub-Saharan Africa was found to be 34.14% (95% CI: 28.74, 39.54%), with substantial heterogeneity (I² = 83.6%), indicates wide variation across the country. Rates varied significantly across countries, ranging from 18.75% in Gabon to 52.8% in Côte d'Ivoire. The weighted concentration index for infant mortality based on women's education was - 0.0072 (95% CI; -0.00134, -0.0012), while the wealth index concentration index was - 0.0093 (95% CI: -0.00154, -0.0032), both with p-values < 0.0001.</p><p><strong>Conclusion and recommendation: </strong>Our analysis reveals that wealth-related disparities in infant mortality disproportionately impact poorer populations in Sub-Saharan Africa, with children of mothers who possess lower socioeconomic status and less education facing higher risks. Factors contributing to these disparities include family size, media exposure, and birth order. The persistence of social injustice is largely due to the inadequate response to these health inequalities. Policymakers must prioritize equitable access to healthcare and consider the socioeconomic distribution of infant mortality in their strategies. To combat these disparities and improve infant survival rates, it is vital to enhance child-rearing practices through targeted health policies, promote equitable economic development, engage communities in health initiatives, and establish monitoring systems. By focusing on these strategies, we can make significant progress toward reducing infant mortality and addressing the underlying social injustices affecting vulnerable populations in line with the goals of Countdown to 2030 and 2063.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2488"},"PeriodicalIF":3.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finding the link of acculturation: the impact of perceived neighbourhood-level residential environment on mental health among rural-to-urban migrants in China.","authors":"Liyan Huang, Tianrong Xu, Hong Ching Goh, Rosli Said, Hui Song, Xinyu Zhang","doi":"10.1186/s12889-025-23652-w","DOIUrl":"10.1186/s12889-025-23652-w","url":null,"abstract":"<p><strong>Background: </strong>The mental health of migrants living in the post-migration urban environment poses a significant public health challenge in both developed and developing economies. Few empirical studies attempted to disentangle the influence pathways that acculturation might produce the link between the residential environment and health effects.</p><p><strong>Methods: </strong>Data from 385 migrants was collected using a multi-stage stratified sampling method from 25 communities in Yiwu, China. We used a multi-level regression model and conditional process analysis to examine the health effects of the perceived neighbourhood environment and influence pathways of acculturation.</p><p><strong>Results: </strong>The results found that participants' mental health was moderate (mean = 15.9 out of 24). Migrants residing in relocation neighbourhoods and factory dormitories exhibit significantly lower mental health. The neighbourhood effects of migrant-dominated, local-dominated, and mixed residential neighbourhoods contribute positively to migrants' mental health. Neighbourhood physical environment positively affects mental health, whereas the neighbourhood social environment negatively affects mental health. Moreover, EGS (β_indirect=-0.04, BootLLCI=-0.096, BootULCI=-0.002) and NSC (β_indirect=-0.038, BootLLCI=-0.081, BootULCI=-0.007) impact migrants' mental health through the mechanism of acculturative stress. Migrants in the assimilation group experienced reduced acculturative stress as the NFA (β=-0.377, p = 0.035) improved. In contrast, those in the separation group faced increased acculturative stress as the improvements of NFA (β = 0.392, p = 0.05) and EGS (β = 0.809, p = 0.027).</p><p><strong>Conclusions: </strong>These findings suggest that future public health intervention strategies should be considered for improved neighbourhood environments, promoted residential integration, alleviated acculturative stress and prioritised acculturation strategies to enhance rural migrants' mental health.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2483"},"PeriodicalIF":3.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving estimators of HIV mortality and retention in care by linking clinical cohort data with national registries in Mexico.","authors":"Lorena Guerrero-Torres, Bibiana Montserrat Barbosa-Ramírez, Pablo F Belaunzarán-Zamudio, Jesús Alegre-Díaz, Raúl Ramírez, Antonio Rosa-Parra, Juan Sierra-Madero, Brenda Crabtree-Ramírez, Yanink Caro Vega","doi":"10.1186/s12889-025-23542-1","DOIUrl":"10.1186/s12889-025-23542-1","url":null,"abstract":"<p><strong>Introduction: </strong>Loss to follow-up (LTFU) bias mortality estimates in cohort studies. This study aimed to estimate the corrected incidence of LTFU, retention in care, and mortality rates in people with HIV (PWH) in an HIV/AIDS Clinic in Mexico City, by linking clinic and national registry data, and to identify characteristics associated with LTFU.</p><p><strong>Methods: </strong>We linked adult PWH who met lost to follow-up criteria while enrolled at a Mexico City clinic with the national death registry, a national administrative HIV database and a clinical national registry in May 2019 and January 2021. We defined lost to follow-up as absence of a documented clinical contact in the previous 180 days. We estimated corrected LTFU, retention in care, mortality rates, and survival, and identified characteristics associated to LTFU.</p><p><strong>Results: </strong>Among 2,826 PWH followed by a median of 5.9 years (IQR: 1.9-7.1), 804 (28.4%) were lost and 149 (5.3%) died. After the second linkage, of the 804 lost, 257 (32%) died, 175 (21.8%) transferred, 40 (4.9%) were retained in care, and 332 (41.3%) remained LTFU. Post second linkage, the corrected cumulative proportion of LTFU slightly decreased (n = 764, 27%), but deaths substantially increased (n = 459, 16.2%). A subset of PWH transferred to other centres (n = 184, 6.5%). The unadjusted LTFU rate decreased from 4.0 to 2.9 per 100 person-years (PY), while mortality increased from 0.7 to 1.7 per 100 PY. Younger age (aHR 1.5, 95%CI 1.38-1.63 per 10-year change), and lower education (aHR 1.05, 95%CI 1.01-1.08 per year) were associated to a higher risk of LTFU.</p><p><strong>Conclusion: </strong>Datasets linkages revealed mortality rates three times higher than the original estimates, highlighting the limitations of relying in single-source data. At the individual level, identifying predictors of LTFU can help target interventions to improve retention and may reduce mortality. However, at the system-level, our study demonstrates the feasibility and value of cross-institutional data linkage in fragmented health systems. Key lessons include the importance of long-term, privacy-preserving data-sharing collaboration between institutions to improve patient tracking across institutions, mortality surveillance and care continuity.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2489"},"PeriodicalIF":3.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12272977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}