Journal of Health, Population, and Nutrition最新文献

Background: Genetic disorders like sickle cell disease (SCD), Thalassemia, and Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency significantly impact social, health, financial, and healthcare systems, affecting 2%-5% of live births, 30% of pediatric hospitalisations, and 50% of juvenile deaths. Premarital carrier screening (PMCS) is a critical preventive measure, yet it remains unexplored in Ghana's Ahafo Region. This study examined young adults' knowledge and factors influencing willingness or unwillingness to undergo PMCS for genetic blood disorders.

Methods: A cross-sectional study was conducted among 460 young adults (18-35 years) in health facilities in the Ahafo Region, Ghana, from January to March 2024. Data was collected using a validated and translated questionnaire to capture socio-demographic characteristics, knowledge of genetic disorders, and factors influencing willingness to undergo PMCS. Data analysis was performed using Stata v14, with statistical significance set at p < 0.05. Chi-square tests were used to assess associations between socio-demographic factors and willingness to undergo PMCS. Logistic regression analysis was conducted to identify predictors of willingness, presenting results as odds ratios (OR) with corresponding p-values.

Results: Among the 460 respondents, most (n = 294; 63.9%) knew their SCD status, but fewer were aware of their G6PD (n = 418; 90.9%) and Thalassemia (n = 441; 95.9%) statuses. A significant number had not tested for SCD (n = 303; 65.9%), G6PD (n = 421; 91.5%), or Thalassemia (n = 446; 97.0%). Among the 460 respondents, 88.5% expressed willingness to undergo PMCS. A chi-square test revealed that sex (χ² = 11.481, p = 0.0032)., education level (χ² = 8.428, p = 0.0379), and parental consanguinity (χ² = 14.336, p = 0.0136) were significantly associated with willingness to undergo PMCS. Logistic regression analysis revealed higher willingness among females [OR = 4.3, p = 0.002], cohabiting individuals [OR = 0.3, p = 0.021], married individuals [OR = 0.1, p = 0.001], self-employed [OR = 0.2, p = 0.047], unemployed [OR = 0.2, p = 0.037], and those informed through school subjects [OR = 0.2, p = 0.036].

Conclusion: Despite low awareness of genetic disorders, willingness to undergo PMCS is high among young adults in the Ahafo Region, highlighting the need for integrated, culturally tailored public health strategies, particularly through school-based education to improve uptake and reduce the burden of hereditary conditions.

Background: Visceral adipose tissue (VAT) is a critical cardiometabolic risk factor, yet the association between the dietary index for gut microbiota (DI-GM) and VAT mass remains unclear.

Methods: This cross-sectional study included 9,805 adults aged 20-59 years from the National Health and Nutrition Examination Survey (NHANES) 2011-2018 (age range based on DXA data availability). DI-GM scores were calculated based on 24-hour dietary recall data using 13 dietary components. VAT mass was directly measured using dual-energy X-ray absorptiometry (DXA). Multivariable weighted linear regression models, restricted cubic spline (RCS) analysis, and subgroup analyses were employed to assess the association between DI-GM and VAT mass.

Results: After comprehensive adjustment for potential confounders, DI-GM score was significantly inversely associated with VAT mass (β = -8.8, 95% CI: -12.0 to -5.5, P < 0.001). Participants in the highest DI-GM quartile (≥ 6 points) had 38.1 g lower VAT mass compared to those in the lowest quartile (0-3 points) (P < 0.001). RCS analysis revealed a linear dose-response relationship with no evidence of nonlinearity (P for nonlinearity = 0.632). Subgroup analyses revealed that this inverse association was more pronounced among individuals aged 40-59 years (β = -12.7, 95% CI: -18.3 to -7.1) and females (β = -12.0, 95% CI: -16.2 to -7.9), with significant interactions detected (P for interaction = 0.001 and 0.032, respectively).

Conclusion: Higher DI-GM scores were significantly associated with lower VAT mass in United States adults. Prospective studies are needed to confirm these findings and establish causal relationships.

Respiratory syncytial virus (RSV) remains a leading cause of infant morbidity and mortality, with the highest burden concentrated in low- and middle-income countries (LMICs). Existing preventive options, including long-acting monoclonal antibodies, can be constrained by cost, logistics, and access, leaving many high-risk infants unprotected. This article is a structured narrative review summarizing clinical efficacy, immunological mechanisms, safety and public health implications of maternal RSV immunization for preventing infant RSV lower respiratory tract infection (LRTI), with an explicit implementation focus for LMICs. Evidence was identified through targeted searches of major biomedical databases and prioritized by clinical relevance and policy importance, including phase III efficacy trials, regulatory and technical documents, post-authorization safety signals, and modelling studies evaluating potential impact in LMICs. Across the evidence base, maternal vaccination induces robust RSV-neutralizing IgG responses and efficient transplacental antibody transfer, providing passive protection during the first months of life when RSV risk is highest. In phase III data, maternal RSV vaccination demonstrated high efficacy against severe medically attended RSV LRTI in early infancy (e.g., up to 81.8% within the first 90 days for a licensed maternal RSV vaccine). Modelling studies project substantial global reductions in hospitalizations and deaths, although real-world effectiveness in LMICs will depend on antenatal care coverage, timing feasibility, seasonality, and equity of delivery. Safety findings were generally favorable; nonetheless, continued post-licensure monitoring,particularly for pregnancy and birth outcomes such as preterm birth,remains essential. Maternal RSV immunization is a scalable strategy that can leverage existing antenatal platforms and, if equitably implemented, could meaningfully reduce infant RSV morbidity and mortality, especially in LMIC settings.

Introduction: Urbanization presents growing public health challenges worldwide, particularly in the Eastern Mediterranean Region (EMR) where rapid urban growth coincides with conflict, migration, and health disparities. The WHO Healthy City Programme (HCP), launched in the 1990s, addresses these through multisectoral urban health initiatives.

Aim: This narrative review examines the HCP's global implementation, with focused analysis of the EMR context.

Methods: A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science, supplemented by WHO and UN documents. Key terms included "Healthy City" and "Urban Health." Only English-language documents addressing HCP implementation were included.

Results: The HCP has expanded to all six WHO regions, with 35 cities certified in the EMR by 2019. The programme emphasizes equity, emergency preparedness and community participation in this region. Implementation challenges include weak institutionalization, limited inter-sectoral collaboration, and inadequate documentation. The paper specifically notes these barriers in the EMR context, along with the need for better monitoring systems. Successful examples from the region demonstrate the programme's alignment with Sustainable Development Goals.

Conclusion: Scaling the HCP in the EMR requires stronger governance frameworks and systematic evaluation. The programme's multisectoral approach remains crucial for addressing urban health challenges, but requires sustained political commitment and adapted strategies for regional implementation.

Background: Preventing healthcare-associated infections (HAIs) depends largely on healthcare workers knowledge and consistent application of infection prevention and control measures. However, despite the availability of global and regional guidelines, significant gaps remain, especially in low-resource settings. In East Africa, existing studies show wide variation in healthcare workers knowledge and practice levels, highlighting inconsistencies in the evidence base. Therefore, this study aimed to assess the knowledge and practice of healthcare workers towards healthcare-associated infection prevention in East Africa through a systematic review and meta-analysis.

Method: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A comprehensive literature search was conducted across databases including PubMed, Embase, Scopus, ScienceDirect, AJOL, and institutional repositories to identify studies assessing healthcare workers' knowledge and practice regarding HAI prevention in East Africa. Meta-analysis was conducted using a random-effects model due to significant heterogeneity, and pooled prevalence estimates with 95% confidence intervals were reported. Subgroup and sensitivity analyses were performed to explore heterogeneity, and publication bias was assessed using funnel plots and Egger's test.

Results: Out of 6,023 identified records, 41 studies met the inclusion criteria and were included in the meta-analysis. These studies, encompassing 11,974 healthcare workers across East African countries, revealed that the pooled prevalence of adequate knowledge regarding HAI prevention was 64.71% (95% CI: 56-72), while the overall prevalence of good infection prevention practices was 55% (95% CI: 50-60). Subgroup analysis indicated that the highest knowledge level was reported in Eritrea (91%), and the lowest in Madagascar (37%). For practice, the highest adherence was observed in Zambia (80%) and the lowest in Sudan (33%). Substantial heterogeneity was noted across studies, prompting further subgroup and sensitivity analyses.

Conclusions: This review found that healthcare workers in East Africa have moderate knowledge and practice levels regarding HAI prevention, with notable variation across countries. To address these gaps, infection prevention and control programs should be strengthened through regular training, adequate resources, and institutional support. Enhanced policy enforcement and further research on country-specific challenges are also recommended.