International Journal of Public Health最新文献

Objectives: To explore the causal association of metabolic syndrome (MetS) and its components [systolic blood pressure (SBP), fasting blood glucose (FG), waist circumference (WC), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG)] with seven infectious diseases (COVID-19 infection, hospitalized COVID-19, very severe COVID-19, bacterial pneumonia, influenza, intestinal infection, and sepsis) using Mendelian randomization (MR) analysis.

Methods: Causal estimates were primarily obtained using the inverse-variance weighted method, with multiple sensitivity analyses conducted to assess heterogeneity and horizontal pleiotropy.

Results: MetS was causally associated with higher risks of COVID-19 infection (OR = 1.09), hospitalized COVID-19 (OR = 1.27), very severe COVID-19 (OR = 1.40), and sepsis (OR = 1.50). Among MetS components, WC increased risks of COVID-19 infection (OR = 1.10), hospitalized COVID-19 (OR = 1.39), very severe COVID-19 (OR = 1.56), bacterial pneumonia (OR = 1.11), and sepsis (OR = 1.42), while HDL-C reduced risks of intestinal infection (OR = 0.96) and sepsis (OR = 0.92).

Conclusion: This MR study supports a causal link between MetS traits and several infectious diseases, emphasizing the importance of metabolic management in reducing infection susceptibility.

Objectives: This cluster randomized controlled trial assessed the effect of a two-day in-person pesticide safety training with or without text messages grounded in behavioral change theory on knowledge, attitude, and practice scores, exposure intensity scores (EIS) during application, and self-reported signs and symptoms of pesticide poisoning among 539 Ugandan smallholder farmers.

Methods: Twelve subcounties were randomized into three groups: educational (n = 180), educational + text messages (n = 179), or control (n = 180). Intervention effects were estimated with mixed-effects regression models using baseline (2021) and follow-up (2022) data.

Results: Knowledge scores increased by 4.4% (95% CI: 0.9, 7.8) and 6.1% (95% CI: 2.7, 9.6) in the educational and in the education + text messages groups, respectively. Attitudes increased by 6.6% (95% CI: 1.8, 11.4) with text messages. Practice scores showed no significant change. Both interventions reduced pesticide exposure, and text messages reduced signs and symptoms of pesticide poisoning by 1.1% (95% CI: -1.7, -0.3).

Conclusion: The limited changes in general practices suggest that generic and content-heavy training programs may hinder implementation. Tailored behavior change approaches, identifying and addressing locally relevant practices and psychosocial drivers, may enhance farmer safety.

Objectives: In the context of the COVID-19 epidemic, adopting preventive behavior could be defined as complying with recommendations issued by public health authorities. The aim of this study was to investigate heterogeneity of preventive behavior changes over time among cancer patients (CPs) during outbreak.

Methods: The PAPESCO-19 study is a multicenter prospective cohort including 893 CPs from French comprehensive cancer centers (June 2020- June 2021). During the 1-year follow-up, CPs completed questionnaires on socio-demographics, lifestyle and COVID-19-related history. Biological and clinical data were collected from medical records. We used the R package lcmm to determine the different classes of preventive behavior trajectories in CPs.

Results: Between June 2020 and April 2022, over two-thirds of CPs reported wearing a mask during all outings. Only one class of preventive behavior was identified. Female CPs, those on sick leave, CPs unable to work due to health reasons and those spending most of the day at home, showed more preventive behavior. CPs with two or more children were less likely to adopt preventive behavior.

Conclusion: No patient clinical characteristics were associated with preventive behavior.

Objectives: Despite compulsory universal health coverage, rising health insurance premiums in Geneva, Switzerland may present financial barriers to care. This study evaluates trends in forgoing healthcare for financial reasons from 2011 to 2025, with associations with insurance premiums, socioeconomic and health-related factors.

Methods: We conducted an annual cross-sectional study with 1,000 randomly selected participants every year (2011-2025), (n = 10,169). The primary outcome was self-reported forgoing of healthcare for financial reasons. Temporal trends and associations with premiums were analyzed using Locally Estimated Scatterplot Smoothing LOESS regression. Logistic regression assessed associations with individual-level determinants.

Results: Overall, 18.1% reported forgoing care, increasing from 15.8% in 2011 to 25.8% in 2025 (+64.6%), corresponding to a 61.9% rise in premiums. Although low income remained a strong predictor (aOR 2.33 [1.76-3.09]), increases were also seen among higher-income groups. Strong correlations were found between premiums and forgoing care, especially in women (0.813) and young adults (0.805).

Conclusion: Additional reforms are needed to reduce growing inequities in access to care despite compulsory universal coverage.

Objectives: This article analyzes the factors associated with neonatal mortality in Burkina Faso, as well as the communal inequalities in this mortality.

Methods: The analysis is based on data from the 2021 Demographic and Health Survey (DHS). It draws on a representative sample of 7,225 children. The determinants of mortality were examined using a log-binomial regression model. For the analysis of geospatial inequalities, the Richardson method was applied to classify communes according to their probability of achieving SDG target 3.2.2 by 2030, distinguishing areas with low, medium, and high likelihoods of attainment.

Results: The analysis reveals an excess risk of neonatal mortality linked to male sex, multiple births, short birth intervals, low maternal education, and limited access to health services. According to the Richardson classification, all communes are on track to meet SDG target 3.2.2 (12‰ by 2030). However, 37 communes show higher residual risks requiring close monitoring.

Conclusion: These results underline the importance of implementing multi-sectoral interventions adapted to territorial specificities in order to effectively maintain the reduction of neonatal mortality in Burkina Faso.

Objective: To estimate the effect of exercise on perinatal depressive symptoms, focusing on subclinical depression.

Methods: Randomized controlled trials (RCTs) reporting Edinburgh Postnatal Depression Scale (EPDS) scores and evaluating perinatal exercise interventions were eligible. A systematic search was conducted in MEDLINE/PubMed, Web of Science, Scopus, and the Cochrane Library for studies published between 2000 and 2024. Study quality, risk of bias, and heterogeneity were assessed before synthesizing the results using a random-effects model.

Results: Nine RCTs met the inclusion criteria. Exercise significantly reduced depressive symptoms (SMD = -0.47; 95% CI = -0.86 to -0.08; p = 0.02) despite high heterogeneity (I² = 88%). Subgroup analyses showed stronger effects during pregnancy (SMD = -0.77; 95% CI = -1.40 to -0.15) than in the postpartum period (SMD = -0.05; 95% CI = -0.31 to 0.22).

Conclusion: Exercise effectively reduces perinatal depressive symptoms and represents a valuable public health intervention. Longer follow-up periods (≥6 months) are needed to confirm the durability of benefits and to evaluate maternal and child outcomes. Future high-quality RCTs with standardized exercise protocols (≥150 min/week of moderate activity) will be essential to translate this evidence into actionable public health and clinical guidelines.

[This corrects the article DOI: 10.3389/ijph.2025.1607770.].

Objectives: The objectives were to estimate the prevalence of out-of-home care among school-aged children in Canada by year, gender, age group, and placement type and assess time trends.

Methods: We analyzed data from five cycles of the Health Behaviour in School-aged Children survey. Respondents were students in grades six through ten attending public schools in Canada. Based on a question about the family structure, we derived three types of living arrangements - (1) foster/children's home, (2) kinship home, or (3) living with a parent(s) - and estimated the prevalence of each type.

Results: The pooled sample included 93,720 students; 1.1% reported living in a foster/children's home and 2.1% in a kinship home and in 2018. At the p = 0.05 level (chi-square), there were no observed differences in prevalence by gender or age group. Over time, the prevalence of living in a kinship home increased more than foster/children's home (average percent change per cycle of 18.5% versus 5.0%), to 2.9% and 1.1%, respectively, in 2018.

Conclusions: The prevalence of out-of-home care in Canada was higher that previous estimates based on census and administrative data.

Objectives: To explore the post-earthquake experiences and perspectives of public health specialists, with a particular focus on the delivery of public health services following the 2023 Kahramanmaraş earthquake.

Methods: This qualitative study employed a phenomenological approach, aiming to capture lived experiences and contextual understanding of the situation. In-depth interviews were conducted with 15 public health specialists. Participants were selected through purposive sampling. Data were collected via in-depth interviews and analyzed thematically using multiple coding by the research team.

Results: Public health specialists reported experiencing stress, burnout, and housing difficulties due to increased workloads and suboptimal working conditions, despite also expressing a sense of professional fulfillment in crisis management. Key challenges included problems in temporary housing, infectious disease control, and insufficient coordination in primary healthcare services and community-based approaches. Poor coordination, vague job roles, and inadequate training and resources were cited as significant barriers to effective disaster response.

Conclusion: The main challenges following the earthquake included increased workloads and unclear role definitions. These findings underscore the importance of establishing pre-defined job descriptions and clear lines of authority to improve disaster preparedness and response in the health sector.

Objectives: To examine disability-related disparities in participation in national health screenings in South Korea and to determine how these gaps vary by disability severity, type, and socio-economic factors.

Methods: A trend analysis of screening participation from 2012 to 2020 and multivariable logistic regression for 2019-2020 were conducted using the National Health Insurance Service database, linking eligibility, health screening, and disability registration data. The cohort comprised 10,413,089 adults aged ≥40 years (20% population sample). Annual screening uptake was the outcome; predictors included disability status, severity, type, employment, sex, income, insurance, and region.

Results: Screening uptake rose overall between 2012 and 2020 yet remained lower for people with disabilities, particularly those with severe physical, visual, communication, mental, developmental, epilepsy, and internal disabilities. Age-sex standardization and socio-economic adjustment attenuated but did not remove gaps. Employment narrowed disparities, whereas women with disabilities faced wider gaps than men.

Conclusion: Despite nationwide gains, disability-related inequities in preventive screening persist, amplified by severe impairment, unemployment, and female gender. Policies should prioritize accessible facilities, targeted outreach, and socio-economic support to ensure equitable screening for people with disabilities.