Tanya Doherty, Sheila Clow, Margreet Wibbelink, Mariatha Yazbek, Soo Downe
{"title":"Midwifery models of care in the context of increasing caesarean delivery rates.","authors":"Tanya Doherty, Sheila Clow, Margreet Wibbelink, Mariatha Yazbek, Soo Downe","doi":"10.2471/BLT.24.293035","DOIUrl":"10.2471/BLT.24.293035","url":null,"abstract":"","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"103 6","pages":"410-412"},"PeriodicalIF":8.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282441","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}
Guillermo A García, Dianna E B Hergott, David S Galick, Olivier Tresor Donfack, Liberato Motobe Vaz, Lucas O Nze Nchama, Jeremías N Mba Eyono, Restituto M Nguema Avue, Matilde Riloha Rivas, Marcos M Iyanga, Faustino E Ebang Bikie, Teresa A Ondo Mifumu, Wonder P Phiri, Michael E von Fricken, Robert C Reiner, David L Smith, Carlos A Guerra
{"title":"Testing indoor residual spraying coverage targets for malaria control, Bioko, Equatorial Guinea.","authors":"Guillermo A García, Dianna E B Hergott, David S Galick, Olivier Tresor Donfack, Liberato Motobe Vaz, Lucas O Nze Nchama, Jeremías N Mba Eyono, Restituto M Nguema Avue, Matilde Riloha Rivas, Marcos M Iyanga, Faustino E Ebang Bikie, Teresa A Ondo Mifumu, Wonder P Phiri, Michael E von Fricken, Robert C Reiner, David L Smith, Carlos A Guerra","doi":"10.2471/BLT.24.292505","DOIUrl":"10.2471/BLT.24.292505","url":null,"abstract":"<p><strong>Objective: </strong>To test 50% indoor residual spraying coverage (percentage of households sprayed) for non-inferiority against the recommended 80% coverage for malaria control.</p><p><strong>Methods: </strong>Indoor residual spraying was done in 2021 and 2022 on Bioko, Equatorial Guinea, in a control arm (80% coverage) and intervention arm (50% coverage) with 37 clusters each. We assessed malaria infection in a representative sample of the population during annual surveys using rapid diagnostic tests. We compared the change in the odds of <i>Plasmodium falciparum</i> infection between baseline and post-intervention using difference-in-differences analysis within a survey-weighted binomial generalized linear model. Given differences between the arms at baseline, we adjusted the model for indoor residual spraying coverage at baseline.</p><p><strong>Findings: </strong>Relative to baseline, the odds of malaria infection post-intervention were 1.11 (95% confidence interval, CI: 0.81-1.52) in the 80% arm and 0.97 (95% CI: 0.72-1.29) in the 50% arm. In the adjusted model, the change in the odds of <i>P. falciparum</i> infection was no greater in the intervention arm than in the control arm (odds ratio: 0.89; 95% CI: 0.58-1.36), with the upper CI being lower than the non-inferiority margin of 1.43.</p><p><strong>Conclusion: </strong>There was no evidence that 50% coverage was inferior in preventing malaria, which supports the use of this target in settings where this level makes indoor residual spraying feasible by increasing the cost-effectiveness and equity of the intervention.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"103 6","pages":"392-402"},"PeriodicalIF":8.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282445","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}
Camille E Morgan, Kimberley A Powers, Jess K Edwards, Upasana Devkota, Stane Biju, Feng-Chang Lin, John L Schmitz, Gavin Cloherty, Jérémie Muwonga, Aimée Mboyo, Pascal Tshiamala, Melchior M Kashamuka, Antoinette Tshefu, Michael Emch, Marcel Yotebieng, Sylvia Becker-Dreps, Jonathan B Parr, Peyton Thompson
{"title":"Children with hepatitis B virus infections, Democratic Republic of the Congo.","authors":"Camille E Morgan, Kimberley A Powers, Jess K Edwards, Upasana Devkota, Stane Biju, Feng-Chang Lin, John L Schmitz, Gavin Cloherty, Jérémie Muwonga, Aimée Mboyo, Pascal Tshiamala, Melchior M Kashamuka, Antoinette Tshefu, Michael Emch, Marcel Yotebieng, Sylvia Becker-Dreps, Jonathan B Parr, Peyton Thompson","doi":"10.2471/BLT.24.292013","DOIUrl":"10.2471/BLT.24.292013","url":null,"abstract":"<p><strong>Objective: </strong>To characterize childhood hepatitis B virus (HBV) epidemiology to inform elimination efforts in the Democratic Republic of the Congo, one of the most populous African countries.</p><p><strong>Methods: </strong>Using the most recent (2013-2014) nationally representative Demographic and Health Survey, we analysed hepatitis B surface antigen (HBsAg) on dried blood spots and associated survey data from children aged 6-59 months. We estimated HBsAg-positivity prevalence nationally, regionally and by potential correlates of infection. We evaluated spatial variation in HBsAg-positivity prevalence overall, and by age, sex and vaccination status.</p><p><strong>Findings: </strong>Using data representing 5773 children, we observed a national HBsAg-positivity prevalence of 1.3% (73/5773; 95% confidence interval, CI: 0.9 to 1.7), ranging from 0.0% in Kinshasa to 5.6% in Sud-Ubangi. Prevalence among boys (1.8%; 95% CI: 1.2 to 2.7) was double that among girls (0.7%; 95% CI: 0.4 to 1.3). Testing negative for tetanus antibodies, rural residence and poorer household were associated with higher HBsAg-positivity prevalence. We observed no difference in prevalence by age. Children had higher HBsAg-positivity odds if living with one or more HBsAg-positive adult household member (odds ratio, OR: 2.3; 95% CI: 0.7 to 7.8), particularly an HBsAg-positive mother (OR: 7.2; 95% CI: 1.6 to 32.3). Notably, nearly two thirds (36/51) of HBsAg-positive children had a HBsAg-negative mother.</p><p><strong>Conclusion: </strong>Our investigation highlights the importance of subnational prevalence estimates in large countries such as the Democratic Republic of the Congo, and we have identified regions that may benefit from improved childhood vaccination delivery strategies and community HBV prevention efforts.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"103 6","pages":"354-365"},"PeriodicalIF":8.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282434","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":"Public health round-up.","authors":"","doi":"10.2471/BLT.25.010625","DOIUrl":"https://doi.org/10.2471/BLT.25.010625","url":null,"abstract":"","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"103 6","pages":"352-353"},"PeriodicalIF":8.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282443","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 difficulty of translating \"well-being\" from English to Arabic.","authors":"Kinda Alsamara, David Forbes","doi":"10.2471/BLT.24.293044","DOIUrl":"10.2471/BLT.24.293044","url":null,"abstract":"","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"103 6","pages":"350-350A"},"PeriodicalIF":8.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282446","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":"Air quality indicators: when data disappear.","authors":"Ankita S Achanta, Ther W Aung","doi":"10.2471/BLT.25.293937","DOIUrl":"10.2471/BLT.25.293937","url":null,"abstract":"","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"103 6","pages":"351-351A"},"PeriodicalIF":8.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282433","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":"In this month's Bulletin.","authors":"","doi":"10.2471/BLT.25.000525","DOIUrl":"https://doi.org/10.2471/BLT.25.000525","url":null,"abstract":"","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"103 5","pages":"285"},"PeriodicalIF":8.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962074","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":"Public health round-up.","authors":"","doi":"10.2471/BLT.25.010525","DOIUrl":"https://doi.org/10.2471/BLT.25.010525","url":null,"abstract":"","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"103 5","pages":"288-289"},"PeriodicalIF":8.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972924","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}
Mary Catherine Sheehan, Ana Boned-Ombuena, Lucinda Cash-Gibson, Alexa Damis-Wulff, Mary A Fox
{"title":"A global assessment of urban extreme weather early warning systems and public health engagement.","authors":"Mary Catherine Sheehan, Ana Boned-Ombuena, Lucinda Cash-Gibson, Alexa Damis-Wulff, Mary A Fox","doi":"10.2471/BLT.24.292205","DOIUrl":"https://doi.org/10.2471/BLT.24.292205","url":null,"abstract":"<p><strong>Objective: </strong>To assess extreme weather early warning systems in large cities across the world.</p><p><strong>Methods: </strong>Among cities with populations above 1 million reporting to the Carbon Disclosure Project Cities Adaptation Actions database from 2021 to 2023, we included those providing a description of at least one adaptation action for a climate hazard in at least one year. We identified cities reporting early warning systems using the United Nations Early Warnings for All framework, which includes four pillars: risk knowledge, hazard monitoring and forecasting, warning communication and preparedness. We also tracked public health engagement in these systems.</p><p><strong>Findings: </strong>We identified 182 cities, of which 71 described full early warning systems across the four pillars. Cities in high- and upper middle-income countries described early warning systems nearly three times more often than those in low- and lower middle-income countries. Multihazard early warning systems were reported by 35 (49%) cities, and many of these involved institutionalized cross-sectoral coordination and funded at least one activity from their own resources. Health was reported as a goal of early warning systems by 58 (82%) cities, although just 29 (41%) indicated a specific role for public health agencies.</p><p><strong>Conclusion: </strong>These findings suggest that many large cities are not covered by these health-protective systems. We recommend development of a city-specific framework for early warning systems that identifies roles for health, and scaling up of these tools, particularly in cities in low- and lower middle-income countries, to ensure strengthened adaptive urban resilience against climate threats.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"103 5","pages":"294-303"},"PeriodicalIF":8.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960632","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}
Tara Danielle Mangal, Margherita Molaro, Dominic Nkhoma, Tim Colbourn, Joseph H Collins, Eva Janoušková, Matthew M Graham, Ines Li Lin, Emmanuel Mnjowe, Tisungane E Mwenyenkulu, Sakshi Mohan, Bingling She, Asif U Tamuri, Pakwanja D Twea, Peter Winskill, Andrew Phillips, Joseph Mfutso-Bengo, Timothy B Hallett
{"title":"Modelling health outcomes of a decade of HIV, malaria and tuberculosis initiatives, Malawi.","authors":"Tara Danielle Mangal, Margherita Molaro, Dominic Nkhoma, Tim Colbourn, Joseph H Collins, Eva Janoušková, Matthew M Graham, Ines Li Lin, Emmanuel Mnjowe, Tisungane E Mwenyenkulu, Sakshi Mohan, Bingling She, Asif U Tamuri, Pakwanja D Twea, Peter Winskill, Andrew Phillips, Joseph Mfutso-Bengo, Timothy B Hallett","doi":"10.2471/BLT.24.292439","DOIUrl":"https://doi.org/10.2471/BLT.24.292439","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the outcome of programmes on human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS), tuberculosis and malaria in Malawi across multiple health domains.</p><p><strong>Methods: </strong>We used an integrated epidemiological and health system model to estimate the impact of HIV/AIDS, tuberculosis and malaria programmes in Malawi from 2010 to 2019. We incorporated interacting disease dynamics, intervention effects and health system use in the model. We examined four scenarios, comparing actual programme delivery with hypothetical scenarios excluding the health programmes individually and collectively.</p><p><strong>Findings: </strong>From 2010 to 2019, an estimated 1.08 million deaths and 74.89 million disability-adjusted life years were prevented by the HIV/AIDS, tuberculosis and malaria programmes. An additional 15 600 deaths from other causes were also prevented. Life expectancy increased by 13.0 years for males and 16.9 years for females. The programmes accounted for 18.5% (95% uncertainty interval, UI: 18.2 to 18.6) of all health system interactions, including 157.0 million screening and diagnostic tests and 23.2 million treatment appointments. Only 41.5 million additional health worker hours (17.1%; 95% UI: 15.9 to 17.4%) of total health worker time) were needed to achieve these gains. The HIV/AIDS, tuberculosis and malaria programmes required an additional 120.7 million outpatient appointments, which were offset by a net decrease in inpatient care (9.4 million bed-days) that would have been necessary in their absence.</p><p><strong>Conclusion: </strong>HIV/AIDS, tuberculosis and malaria programmes have greatly increased life expectancy and provided direct and spill-over effects on health in Malawi. These investments reduced the burden on inpatient and emergency care, which requires more intensive health worker involvement.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"103 5","pages":"304-315"},"PeriodicalIF":8.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954588","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}