Journal of Public Health Research最新文献

Background: Hypertension is a significant global health issue, including in Ethiopia, where it remains poorly controlled despite effective treatments, leading to complications and death. This study aimed to estimate time to death and identify predictors among adult hypertensive patients in Dire Dawa, Ethiopia.

Method: A retrospective cohort study was conducted among 530 randomly selected adult hypertensive patients from June 28, 2020 to June 28, 2023. Data were collected by Kobo Toolbox and cleaned in Excel, while analysis was done by Stata version 17. The Kaplan-Meier survival curve was computed to estimate the time to death. A log-rank test was used to compare the differences in survival distributions among groups of independent variables. Cox proportional hazards regression models were fitted to identify the predictors of time to death. A p-value of <0.05 was considered significant.

Results: The median survival time was 24 months, with a mortality rate of 7.9 per 1000 person-months. Significant independent predictors of mortality included higher education (AHR: 0.17), use of amlodipine (AHR: 0.19), combining amlodipine and hydrochlorothiazide (AHR: 0.17), smoking (AHR: 6.64), alcohol consumption (AHR: 2.66), obesity (AHR: 5.55), being overweight (AHR: 5.66), and having comorbidities (AHR: 3.84).

Conclusion: Factors such as education, medication adherence, lifestyle choices, and comorbidities significantly influence mortality among hypertensive patients. Comprehensive management strategies addressing these risk factors are crucial for improving survival in similar healthcare settings.

Background: Kazakhstan implemented a diagnosis-related group (DRG)-based payment system in 2012, transitioning from a fee-for-service remuneration model for public hospitals. The reform aimed to enhance hospital efficiency and cost control. A national rollout was preceded by a pilot phase involving 21 hospitals in 2011. While DRG systems are increasingly adopted and adapted globally, evidence on their effects remains limited in low- and middle-income countries.

Objective: To assess whether the introduction of the DRG-based system is associated with changes in hospital activity and the quality of care.

Design and methods: A controlled interrupted time series design was employed, using matched control hospitals to estimate the causal impact of the payment reform. The analysis was based on weekly hospital discharge data from the 2011/2012 to 2012/2013 fiscal years, obtained from the Ministry of Health.

Result: Findings suggest that the impact of the reform on hospital activity varied by hospital levels, with pilot hospitals showing a quicker response to nationwide implementation. No significant effects were observed on quality of care, as measured by standardised in-hospital mortality rates.

Conclusions: The introduction of the DRG-based payment system was associated with heterogenous effects on hospital activity but did not yield measurable short-term improvements in care quality. These findings underscore the importance of implementation context and highlight the need for further research to assess long-term and system-wide effects.JEL classification: H51, I1, P36.

Background: Central obesity, characterized by excess fat as measured by waist circumference, is a significant public health concern that impacts health outcomes in both developed and developing countries, including Ethiopia. This study aimed to assess the prevalence of central obesity and its associated factors among adult public sector workers in Jigjiga town, Somali Region, Eastern Ethiopia.

Design and methods: An institutional cross-sectional study was conducted from April 15-30, 2024, among 628 public sector workers selected by a multistage sampling method in Jigjiga town, Somali region, Eastern Ethiopia. Data was collected using a pretested structured questionnaire. Descriptive analysis was done. Bivariable and multivariable logistic regression analyses were performed to assess associations. The strength of associations between central obesity and independent variables was determined by adjusted odds ratios (AORs) with 95% confidence intervals.

Results: Of the 628 public sector workers included in April 2024, the prevalence of central obesity was 48.6% (95% CI: 44.7%-52.6%), with 46.7% in males and 53.4% in females. Being female (AOR = 1.52, 95% CI = 1.04-2.21), physical inactivity (AOR = 2.02, 95% CI = 1.14-3.58), eating red meat 1-2 times per week (AOR = 1.55, 95% CI = 1.02-2.34), being non-diabetic patients (AOR = 0.35, 95% CI = 0.12-0.97), and non-stressful work (AOR = 0.38, 95% CI = 0.17-0.85) were significantly associated with central obesity.

Conclusion: The prevalence of central obesity among public sector workers in this study was high. As a result, interventions should focus on promoting physical activity through workplace wellness programs, encouraging healthier dietary choices, providing resources for stress management, and monitoring health and work environments, along with behavioral change interventions, which would be crucial in reducing central obesity among public sector workers.

Background: Occupational hazards in the veterinary field are a significant concern due to the nature of the profession. Veterinary students are particularly vulnerable, as they often engage in clinical and laboratory activities before completing their degrees and may lack adequate experience. This was the first attempt to assess the knowledge, attitudes, and practices regarding occupational hazards among veterinary students.

Design and methods: A cross-sectional study was conducted among 330 veterinary students from two conveniently selected institutions in Bangladesh. Third- to fifth-year students were approached to participate in a self-administered survey. Data were analyzed using descriptive and inferential statistics, including the chi-square test, Spearman's correlation, and logistic regression to identify associated factors.

Results: Among participants, 77.9% were familiar with the term "occupational hazard," and over half of them had a lower level of knowledge (53.7%). More than half (54.2%) demonstrated poor attitudes among total respondents. Notably, 8.5% never used personal protective equipment, and 23.6% were not vaccinated against potential occupational diseases. Recapping needles after use was reported by 87.3% respondents. Familiarity with occupational hazards was associated with educational institution and curricular education exposure. Academic levels, formal training outside the curriculum, and curricular education exposure were linked to knowledge. Moreover, the current year of study and exposure to formal training outside the curriculum were associated with attitude.

Conclusion: The findings from the study highlight the need to strengthen veterinary students' knowledge, attitudes, and practices regarding occupational hazards by integrating theoretical and practical training into the curriculum prior to clinical exposure.

This study aims to analyze the global research landscape on Willingness to Pay (WTP) for Community-Based Health Insurance (CBHI) from 2002 to 2024. It seeks to identify key trends, influential contributors, regional disparities, and thematic focus areas, offering insights to guide future research and policy development. A bibliometric analysis was conducted using 354 documents sourced from Dimensions, Scopus, and PubMed. The Bibliometrix package in R Studio, along with the Biblioshiny application, was employed to examine publication trends, citation metrics, collaboration networks, and keyword distributions. Bradford's and Lotka's Laws were applied to evaluate journal productivity and author contribution patterns. Data visualizations, including geographical distribution maps and author productivity charts, were used to present findings. The analysis revealed an annual publication growth rate of 10.12%. Ethiopia led in research output (15.8%), while Burkina Faso's publications were most cited. International collaborations were present in 31.64% of studies, indicating increasing global engagement. Key publishing journals included BMC Health Services Research and PLOS ONE. Influential authors such as Sauerborn R and De Allegri M emerged as central figures in the field. The field of WTP for CBHI is expanding and contributing to the discourse on healthcare financing and equity, especially in LMICs. However, research contributions were regionally skewed, with underrepresentation from South America and Oceania, and a notable reliance on a small group of productive authors. To strengthen CBHI's potential for achieving universal health coverage, it is crucial to address regional research disparities, foster interdisciplinary collaboration, and explore emerging areas such as behavioral economics and technology integration.

Background: There is little consensus on what public health survey administration methods are better (data generation and cost-wise) for collecting data on knowledge, attitudes, and beliefs (KAB). We compare random digit dialing (RDD) and internet panel sampling methods for gathering KAB data on chronic disease etiology and nutrition policy.

Design and methods: We collected survey data from residents of Alberta and Manitoba in 2017, using population-based samples generated through: RDD and an internet panel. We calculated response rate and cost for each mode. To compare missing data and straightlining, we used linear regression. We used Chi-squared tests to compare sociodemographic characteristics between the two modes and to the 2016 Canadian Census data. KAB responses were also compared between modes using Chi-squared tests.

Results: The internet panel was less expensive and had more missing data than the RDD. Straightlining was comparable across modes. Both modes tended to oversample specific population groups (e.g. older adults); while undersampling others (e.g. Indigenous people) compared to the Canadian Census. RDD had more females and older respondents than the internet panel respondents. Internet panel respondents were less supportive of nutrition policy options, and agreed more with individual responsibility and blame for obesity, compared to RDD respondents.

Conclusions: Both modes present advantages and disadvantages. Differences in sociodemographics and KAB responses between modes indicate sampling methods for public health surveys may be considered in survey design and administration. Researchers should discuss their findings vis-a-vis the specific limitations of each method they employed and adopt strategies to mitigate them.

Background: The misuse of antibiotics is fueling antimicrobial resistance (AMR), a critical public health threat. In settings of severe economic crisis, these challenges are often amplified, impacting public access to and appropriate use of medications. This study assessed the knowledge, attitudes, and practices (KAP) of the Lebanese population regarding antibiotic use and AMR, contextualized within the nation's ongoing economic crisis.

Design and methods: A cross-sectional study was conducted from July to December 2023 using an anonymous questionnaire distributed online and in-person across Lebanon. Data were analyzed using t-tests, ANOVA, and Pearson correlation.

Results: Among 409 participants, significant knowledge gaps and common misconceptions were evident: only 44.74% knew antibiotics are ineffective against viruses, just 24.69% recognized the lethality of AMR, and many incorrectly used antibiotics for a fever (36%) or cough (26.41%). Critically, these knowledge gaps translated into high-risk behaviors shaped by the economic crisis; 42.06% reported financial constraints influenced their antibiotic use, leading to cost-avoiding practices like using leftover medications (41.81%) and sharing them (31.05%). Demographically, higher educational levels and female gender were associated with better knowledge (p = 0.043 and 0.010, respectively). Statistically, a moderate positive correlation was found between knowledge and practice (r = 0.455, p < 0.001), linking lower knowledge to riskier behaviors.

Conclusions: This study reveals a dual challenge in Lebanon: widespread misconceptions about antibiotics are compounded by economic pressures that shape patient behavior. Our findings indicate that financial constraints directly influence antibiotic access and self-medication practices. Therefore, effective interventions require a two-pronged approach: strengthening public health education to address knowledge gaps, while simultaneously developing policy solutions to ensure equitable antibiotic access and mitigate the impact of economic hardship on appropriate use and the fight against AMR.

Background: Herbal medicines are widely used globally; however, public awareness of their appropriate use and potential adverse effects remains limited. This study aimed to assess the knowledge and awareness of herb-drug interactions among the general population in Saudi Arabia, a context where research in this area is scarce.

Methods: A cross-sectional survey was conducted using an electronic questionnaire disseminated through social media platforms. Data were analyzed with SAS® version 9.4, and multiple linear regression analyses were performed to identify factors associated with participants' knowledge scores.

Results: A total of 834 respondents participated in the study. The majority were female (64.4%) and married (48.7%). More than half of the participants (57%) demonstrated moderate knowledge of herb-drug interactions. Age and region were negatively associated with knowledge levels, whereas female gender and prior use of herbal products were positively associated.

Conclusions: The findings reveal a moderate level of public knowledge regarding herb-drug interactions in Saudi Arabia. Targeted educational initiatives and public health interventions are urgently needed to improve awareness and promote safe practices.

Youth-led interventions are increasingly recognized as vital in advancing global tobacco control, yet their ethical and strategic dimensions remain underexplored. Building on the study by Karki et al., which demonstrated that youth-led awareness and advocacy interventions can positively influence adolescents' attitudes toward tobacco products in Nepal, this letter highlights two key considerations. First, youth participation must move beyond symbolic engagement toward genuine power-sharing within decision-making structures, ensuring that adolescents are treated as co-governors rather than temporary campaigners. Second, attitudinal change should be situated within broader structural dynamics, particularly the influence of the tobacco industry. Without enforceable reforms such as taxation, advertising restrictions, plain packaging, and protection from industry interference, youth empowerment risks being undermined. We argue for an integrated approach that combines empowerment, governance, and structural reform to transform short-term attitudinal shifts into sustained intergenerational public health gains.

Plastic packaging is produced through a process called polymerization, where monomers (the building blocks) are linked together. Usually, monomers are stable in the polymer chain; however, the presence of low molecular weight substances, such as LDPE, prevents the monomers from being packaged closely. This leads to their spread to food through various means, such as contact, penetration, gas-phase diffusion, condensation, and set-off migration. Although their quantity is lower in the packaging, after consumption, their concentration increases to levels that can be detrimental to human health.