Clinical Epidemiology and Global Health最新文献

{"title":"Assessing the epidemiological and economic impact of dengue from 1990 to 2021 in Indonesia","authors":"Wahyu Pudji Nugraheni ,&nbsp;Syarifah Nuraini ,&nbsp;Triwibowo Ambar Garjito ,&nbsp;Indah Pawitaningtyas ,&nbsp;Sinta Dewi Lestyoningrum ,&nbsp;Linta Meyla Putri ,&nbsp;Afi Nursafingi ,&nbsp;Asep Kusnali ,&nbsp;Adistha Eka Noveyani ,&nbsp;P.W. Dhewantara","doi":"10.1016/j.cegh.2026.102303","DOIUrl":"10.1016/j.cegh.2026.102303","url":null,"abstract":"<div><h3>Problem considered</h3><div>Dengue fever remains a significant public health problem in Indonesia, one of the country's most severely affected in Southeast Asia. Despite ongoing control efforts, the disease continues to cause major health and economic impacts. This study aimed to evaluate the epidemiological and economic impact of dengue.</div></div><div><h3>Method</h3><div>An ecological time-trend analysis was performed using secondary data from the Global Burden of Disease (GBD) 2021 database, national health statistics, and provincial minimum wage data. Dengue incidence, mortality, and DALYs were mapped and quantified across 34 provinces, and economic losses were estimated using a human capital approach. Geospatial analyses visualized regional disparities.</div></div><div><h3>Results</h3><div>Indonesia's age-standardized dengue incidence peaked in 2015 (912.4 per 100,000 among males; 1076.7 among females). Females showed consistently higher incidence, while males experienced higher mortality; DALYs increased sharply between 2005 and 2017 before stabilizing. The highest DALYs and economic losses (&gt;IDR 6 trillion combined) were observed in West Java, East Java, and Central Java. Marked geographic disparities correlated with variations in population density, healthcare access, and vector control capacity.</div></div><div><h3>Conclusion</h3><div>Dengue imposes a heavy and sustained health and financial burden in Indonesia, with dense provinces most impacted. Interventions such as strengthened surveillance, region-specific vector control, improved urban sanitation, and expanded healthcare access are essential to limit further losses. Economic analysis highlights urgent needs for resource allocation and locally tailored responses to mitigate dengue's impact.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102303"},"PeriodicalIF":1.7,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"May Measurement Month (MMM) program 2021–2024: Results of a community screening program in can Tho city, Vietnam","authors":"Son Kim Tran ,&nbsp;Cuong Tan Vo ,&nbsp;Phuong Minh Nguyen ,&nbsp;Dung The Bui ,&nbsp;Chau Minh Tran ,&nbsp;Toan Hoang Ngo ,&nbsp;Minh Van Huynh","doi":"10.1016/j.cegh.2026.102302","DOIUrl":"10.1016/j.cegh.2026.102302","url":null,"abstract":"<div><h3>Problem considered</h3><div>Hypertension (HTN) remains one of the most pressing global health challenges, straining healthcare systems. The May Measurement Month (MMM) campaign aims to raise blood pressure (BP) awareness and address screening gaps. This study screened volunteers aged ≥18 for HTN and cardiovascular risk factors to assess prevalence, awareness, and management effectiveness.</div></div><div><h3>Methods</h3><div>This study employed a cross-sectional, opportunistic survey design. Data were collected from adults aged ≥18 years between 2021 and 2024 as part of the MMM initiative.</div></div><div><h3>Results</h3><div>Among 4105 participants (mean age 53.0 ± 15.3 years), 37.2 % had HTN. Of untreated individuals, 72.5 % were hypertensive, while 53.4 % of treated cases remained uncontrolled (BP ≥ 140/90 mmHg). HTN prevalence rose from 28.9 % (2021) to 47.8 % (2024), with BP control improving to 46.5 % (p &lt; 0.001). HTN was highest in ≥60 years (46.8 %) and lowest in &lt;45 years (15.4 %), while BP control remained stable (33.5 %–35.1 %). Males had higher HTN prevalence, though BP control differences were not significant (p &gt; 0.05). In univariate analyses, HTN was associated with smoking, alcohol use, overweight–obesity, pregnancy, and cardiovascular comorbidities. In the multivariate model from MMM 2021–2024, independent contributors to HTN included older age, heart attack, stroke, diabetes, and physical inactivity, whereas smoking and male sex did not retain statistical significance.</div></div><div><h3>Conclusion</h3><div>The MMM 2021–2024 campaign, conducted during COVID-19, highlighted the need for BP screening in Vietnam. Despite pandemic challenges, undiagnosed and uncontrolled HTN remain major concerns. Standardized screening like MMM remains crucial for detecting high BP and improving HTN management.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102302"},"PeriodicalIF":1.7,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Connotation of serum levels of vitamin D3 and LL-37 with urinary tract infection in type 2 diabetic patients","authors":"Zahraa A. Hashim","doi":"10.1016/j.cegh.2026.102299","DOIUrl":"10.1016/j.cegh.2026.102299","url":null,"abstract":"<div><h3>Problem considered</h3><div>Type 2 diabetes mellitus (T2DM) is characterized by inappropriacy of innate immunity leading to higher rates of urinary tract infection (UTI), an important risk factor for urinary tract complications. 25-hydroxy vitamin D may donate, via the production of the antimicrobial peptide cathelicidin (LL-37), to epithelial host defense against colonization of uro-pathogens. This study aimed to assess serum levels of vitamin D₃ and LL-37 in T2DM patients with and without UTI and to measure the association of these two parameters with metabolic profile and microbial distribution pattern.</div></div><div><h3>Methods</h3><div>Patients' characteristics were documented and included patients’ age, sex, duration of being diagnosed with T2DM, concurrent treatments, other diseases, body mass index, and smoking status. Blood sample was collected from each enrolled patient for metabolic profiling, serum vitamin D_3, and LL-37 measurement. Urine sample was collected for urinalysis and patients were grouped accordingly into with-UTI (group A) and without-UTI (group B) groups.</div></div><div><h3>Results</h3><div>One hundred and twelve T2DM patients (aged 51.1 ± 5.8 years) were enrolled; 50 patients with UTI and 62 without. Serum levels of vitamin D₃ were found to be significantly lower in patients with UTI (17.9 ± 4.8 ng/mL) than in patients without UTI (25.2 ± 5.7 ng/mL) (p &lt; 0.01). In accordance, LL-37 levels were significantly reduced in group A members (27.5 ± 6.9 ng/mL) when compared to group B members (35.5 ± 8.6 ng/mL) (p-value &lt;0.01). <em>E. coli</em> was the most common isolated uro-pathogen (40 %) followed by <em>P. aeruginosa</em> and <em>S. aureus</em> (14 % each), <em>Enterobacter</em> (10 %), <em>Klebsiella</em> spp (8 %) and <em>Proteus</em> spp (4 %). No significant difference in serum LL-37 levels was encountered between the three types of microbial isolates (p-value &lt;0.05). A strong positive correlation was reported between LL-37 and vitamin D₃ levels in patients without UTI (<em>r</em>_<em>s</em>: 0.9855, p-value: &lt;0.01). A weak, though non-significant, correlation was observed between LL-37 and vitamin D₃ in patients with UTI (<em>r</em>_<em>s</em>: 0.25283, p-value: &gt;0.05).</div></div><div><h3>Conclusion</h3><div>Findings suggest that diminished serum levels of vitamin D₃ and LL-37 could have clinical implications and could act as a potential immunological indicator for the tendency to develop UTI in diabetic patients.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102299"},"PeriodicalIF":1.7,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and determinants of time to first intimate partner violence incidents among ever-married Ethiopian women","authors":"Ashefet Agete Mengste ,&nbsp;Denekew Bitew Belay ,&nbsp;Haile Mekonnen Fenta ,&nbsp;Ding-Geng Chen","doi":"10.1016/j.cegh.2026.102300","DOIUrl":"10.1016/j.cegh.2026.102300","url":null,"abstract":"<div><h3>Background</h3><div>Intimate partner violence (IPV), including physical, emotional, and sexual abuse disproportionately affects women globally, particularly in sub-Saharan Africa.</div></div><div><h3>Objective</h3><div>This study examined the timing and determinants of first experiences of IPV among ever-married Ethiopian women.</div></div><div><h3>Participants and setting</h3><div>The study analyzed nationally representative data from 4720 ever-married women who participated in the 2016 Ethiopian Demographic and Health Survey.</div></div><div><h3>Methods</h3><div>Cox proportional hazards and parametric accelerated failure time (AFT) models were used to identify factors influencing time to first IPV. Women who had not experienced IPV by the survey date or who reported IPV occurring before marriage were treated as right-censored. Multiple AFT distributions were compared, and the best-fitting models were selected.</div></div><div><h3>Results</h3><div>Approximately 30 % of women reported experiencing at least one form IPV, most commonly emotional (22.3 %). The log-normal AFT model best fit physical and sexual violence, while the Weibull AFT model fit emotional violence. Older women (35–49 years) experienced IPV later than younger women (time ratios [TR]: 2.09 physical, 2.82 sexual, 3.00 emotional). Husband's alcohol use, controlling behavior, family violence history, and fear of the husband were associated with earlier IPV occurrence (TR &lt; 1). More children delayed physical and emotional violence (TR &gt; 1), while older age at marriage predicted earlier emotional violence (TR = 0.7).</div></div><div><h3>Conclusions</h3><div>Age, regional differences, family background, and husbands' behaviors significantly influence the timing of IPV onset among Ethiopian women. Targeted prevention programs addressing harmful partner behaviors, alcohol use, and intergenerational violence are essential to delay or prevent IPV and safeguard women's wellbeing.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102300"},"PeriodicalIF":1.7,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prognostic value of frailty in hospitalized older adults with chronic heart failure: A short-term follow-up study in Vietnam","authors":"Tri Van Nguyen ,&nbsp;Tran To Tran Nguyen ,&nbsp;Yen Thi Bao Nguyen ,&nbsp;Tai Huy Kien Pham","doi":"10.1016/j.cegh.2026.102298","DOIUrl":"10.1016/j.cegh.2026.102298","url":null,"abstract":"<div><h3>Problem considered</h3><div>To evaluate the impact of frailty on adverse outcomes, including hospital readmissions and mortality among older patients with chronic heart failure (CHF) in Vietnam.</div></div><div><h3>Methods</h3><div>This prospective, observational study was conducted in the cardiology departments of two general hospitals in Ho Chi Minh City between July 2023 and March 2024. Frailty was assessed using the Clinical Frailty Scale (CFS). Baseline evaluations included frailty status, demographic characteristics, comorbidities, and laboratory results. Patients were followed for three months post-discharge to monitor hospital readmissions, mortality, and composite outcomes (readmission and/or death).</div></div><div><h3>Results</h3><div>A total of 214 older Vietnamese patients with CHF participated in the study. Frailty was very common, affecting 74.3 % of the group. Within three months after hospital discharge, the rates of readmission, death, and combined adverse events were 44.9 %, 2.3 %, and 46.3 %, respectively. After adjusting for potential confounders, frailty was independently associated with a significantly increased risk of both hospital readmission (adjusted hazard ratio [aHR]: 2.42; 95 % CI: 1.13–5.25; p = .026) and composite events (aHR: 2.67; 95 % CI: 1.22–5.82; p = .014). Subgroup analysis revealed that no statistically significant association was observed between frailty and adverse outcomes in patients with heart failure with preserved ejection fraction (HFpEF).</div></div><div><h3>Conclusion</h3><div>Pre-discharge frailty was independently associated with short-term adverse outcomes in older adults hospitalized with chronic heart failure. Given the three-month follow-up period, these findings underscore the potential value of routine frailty assessment in identifying individuals at high risk.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102298"},"PeriodicalIF":1.7,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing the childbirth experience of mothers underwent labour induction in Northwest Ethiopia: A Mixed-methods Study","authors":"Srawork Tesfaye ,&nbsp;Endeshaw Admasu ,&nbsp;Eden Bishaw Taye ,&nbsp;Mengstu Melkamu Asaye","doi":"10.1016/j.cegh.2026.102296","DOIUrl":"10.1016/j.cegh.2026.102296","url":null,"abstract":"<div><h3>Background</h3><div>Induction of labor is an obstetric intervention. It can be a significant biomedical and psychosocial event, resulting in a range of positive or negative childbirth experiences. Gaining in-depth knowledge in these areas may help improve the quality of care and the utilization of maternity services. However, in Ethiopia, no studies have been conducted to date.</div></div><div><h3>Objective</h3><div>To assess mothers’ childbirth experiences and influencing factors among those who underwent induction of labor.</div></div><div><h3>Methods</h3><div>A facility-based mixed-methods study was conducted from 5 May to August 20, 2025 among 422 mothers. Data were collected using contextualized tools. Audio transcription and translation were performed for the qualitative data. Logistic regression analysis was used, with a P-value of less than 0.05 considered significant. Thematic analysis was applied to the qualitative data.</div></div><div><h3>Results</h3><div>The proportion of positive childbirth experiences was 236 (55.9 %) (95 % CI: 51.2–60.7). Being multiparous (AOR = 8.63, 95 % CI: 5.21–14.27), having a vaginal delivery (AOR = 2.11, 95 % CI: 1.31–3.41), age under 20 (AOR = 4.65, 95 % CI: 1.53–14.13), and age 21–30 (AOR = 2.35, 95 % CI: 1.22–4.51) were associated factors. The identified facilitators were trust building at admission, clear communication, and labour pain coping strategies. In contrast, feeling disturbed and lack of involvement were barriers that negatively affected mothers' childbirth experiences.</div></div><div><h3>Conclusion</h3><div>The proportion of positive childbirth experiences was moderate. Building trust, clear communication with healthcare providers, and strategies to manage labour pain were facilitators. Emotional disturbances and lack of involvement were barriers to a positive childbirth experience.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102296"},"PeriodicalIF":1.7,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biologic treatment outcomes in rheumatoid arthritis: Biomarker response and cost-effectiveness analysis in an Albanian cohort","authors":"Dorela Hasankolli ,&nbsp;Mirela Miraci ,&nbsp;Silvi Bozo ,&nbsp;Teuta Backa ,&nbsp;Marsida Mulaj ,&nbsp;Entela Haloci ,&nbsp;Fatjola Ferrollari","doi":"10.1016/j.cegh.2026.102301","DOIUrl":"10.1016/j.cegh.2026.102301","url":null,"abstract":"<div><h3>Background</h3><div>Rheumatoid arthritis (RA) is a chronic autoimmune disease causing progressive joint damage, disability, and high healthcare costs. Biologic DMARDs have improved outcomes, but responses vary. Identifying predictive biomarkers and evaluating cost-effectiveness are essential, particularly in resource-limited settings like Albania.</div></div><div><h3>Methods</h3><div>A retrospective cohort study at Mother Teresa University Hospital Center, Tirana, included 162 RA patients treated with bDMARDs (2021–2024). All met ACR/EULAR criteria and had biomarker data at baseline and six months. ESR, CRP, fibrinogen, RF, and anti-CCP were analyzed using paired t-tests (p &lt; 0.05). Cost-effectiveness analysis compared direct drug costs with biomarker improvement across adalimumab and tocilizumab using ICERs.</div></div><div><h3>Results</h3><div>Tocilizumab (46.8 %), adalimumab (37.1 %), and etanercept (16.1 %) were the main bDMARDs used. ESR, CRP, and fibrinogen significantly decreased (p &lt; 0.01). Six-month direct costs were 1136.20 USD for adalimumab, 2233.40 USD for etanercept, and 4069.00 USD for tocilizumab. Adalimumab demonstrated the best cost-effectiveness, with the lowest cost per unit biomarker reduction (ESR 87.40 USD/mm/h; CRP 59.80 USD/mg/L; fibrinogen 1456.66 USD/g/L). Tocilizumab achieved the greatest biomarker reductions but had the highest price (156.60 USD/unit) and incremental costs, with ICERs of 2932.80 USD vs. adalimumab, below Albania's 3 × GDP threshold (∼21,000 USD) for ESR and CRP, but near/exceeding it for fibrinogen.</div></div><div><h3>Conclusions</h3><div>Among available biologics, adalimumab shows the most favorable cost-effectiveness, while tocilizumab may be justified in non-responders to TNF inhibitors. Etanercept was considered economically dominated and was not included in the incremental cost-effectiveness analysis. Biomarker-guided assessment supports cost-effective and evidence-based management of RA in Albania.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102301"},"PeriodicalIF":1.7,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cow's milk protein-induced FPIES: Clinical outcomes in severe cases","authors":"Príscila da Silva Pereira Vasconcelos,&nbsp;Tassiana dos Anjos,&nbsp;Juliana Bellote,&nbsp;Elizete Aparecida Lomazi,&nbsp;Maria Ângela Bellomo-Brandão","doi":"10.1016/j.cegh.2025.102235","DOIUrl":"10.1016/j.cegh.2025.102235","url":null,"abstract":"<div><h3>Problem considered</h3><div>Food Protein-Induced Enterocolitis Syndrome (FPIES) is a rare and poorly understood condition that primarily affects infants and young children. This study aimed to evaluate the clinical characteristics and outcomes of patients diagnosed with severe cow's milk protein-induced FPIES.</div></div><div><h3>Methods</h3><div>A case series was conducted involving pediatric patients who underwent oral food challenges OFCs for FPIES exclusively triggered by cow's milk protein, followed at the pediatric gastroenterology outpatient clinic of a quaternary hospital between January 16, 2018, and June 20, 2024.</div></div><div><h3>Results</h3><div>A total of six patients were included, and 24 OFCs were assessed. The median age at symptom onset was 44 days (range: 3–99 days). Before the first OFC, the median duration of the elimination diet was 11.2 months (Q1: 8.7 – Q3: 27 months; IQR: 18.3 months); for patients requiring additional OFCs, the median duration was 35.17 months (Q1: 27.27 – Q3: 72.2 months, IQR: 44.93). All patients required admission to the intensive care unit. Two patients were formula-fed, three received mixed feeding, and one received whole cow's milk. Three patients had a family history of atopy, and one had a personal history of atopy. One patient had Down syndrome (DS), one was otherwise healthy, one had a genetic disorder (3p deletion/16q duplication), and three patients had cytomegalovirus infection. All patients developed tolerance to cow's milk protein, with a median time of 33 months (range: 17–103 months).</div></div><div><h3>Conclusions</h3><div>While the overall prognosis of FPIES was favorable, managing cases with severe initial symptoms necessitating ICU admission is complex and frequently involves multiple OFC before achieving tolerance.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102235"},"PeriodicalIF":1.7,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between postpartum depression and exclusive breastfeeding practices among urban mothers, Bhubaneswar, Odisha","authors":"Deepanjali Behera ,&nbsp;Manasmruti Sahu ,&nbsp;Manas Ranjan Behera ,&nbsp;Magnus Micchael Sichalwe ,&nbsp;Manatee Jitanan ,&nbsp;Janmejaya Samal ,&nbsp;Ranjit Kumar Dehury ,&nbsp;Damodar Jena","doi":"10.1016/j.cegh.2025.102259","DOIUrl":"10.1016/j.cegh.2025.102259","url":null,"abstract":"<div><h3>Problem considered</h3><div>Postpartum depression (PPD) involves persistent sadness, fatigue, and bonding difficulties, while exclusive breastfeeding (EBF) means feeding infants only breast milk for six months. Both are vital for maternal and child health, yet their relationship is understudied. This study examined the prevalence of PPD among mothers in urban Bhubaneswar, Odisha, and its association with EBF.</div></div><div><h3>Methods</h3><div>An analytical cross-sectional study was conducted among 107 postpartum mothers in urban Bhubaneswar from February to April 2024. A pre-designed questionnaire captured socio-demographic characteristics and breastfeeding practices. Data were analyzed using SPSS version 27. Univariate analysis described variables, bivariate analysis assessed associations between categorical variables, and multivariate analysis identified predictors of postpartum depression at a significance level of p ≤ 0.05.</div></div><div><h3>Results</h3><div>Among the mothers surveyed, 12.1 % reported postpartum depression, while 94.4 % practiced exclusive breastfeeding. Cesarean delivery was associated with over fourfold higher odds of depression compared to vaginal delivery (AOR = 4.41, 95 % CI: 2.19–16.27, p = 0.001). Mothers who planned to breastfeed for ≤12 months (AOR = 5.34, 95 % CI: 1.07–26.61, p = 0.04) and those intending 12–24 months (AOR = 10.28, 95 % CI: 1.14–93.14, p = 0.03) also had significantly greater odds of postpartum depression compared to those planning &gt;24 months.</div></div><div><h3>Conclusion</h3><div>Postpartum depression is linked to normal vaginal delivery and shorter planned breastfeeding durations. Early screening and breastfeeding support are essential to improve maternal mental health and infant care.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102259"},"PeriodicalIF":1.7,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reasons for medication non-adherence among diabetes mellitus patients in Kelantan: A cross-sectional study","authors":"Thamron Keowmani ,&nbsp;Erwan Ershad Ahmad Khan ,&nbsp;Siti Farhain Amir ,&nbsp;Suzita Mukhtar ,&nbsp;Raja Nurul Fatin Raja Kamaruzaman ,&nbsp;Kok Han Lim ,&nbsp;Mohd Azri Mohd Khatib ,&nbsp;Nurul Ezzati Arifin ,&nbsp;Siti Nur Sarah Saharudin","doi":"10.1016/j.cegh.2026.102297","DOIUrl":"10.1016/j.cegh.2026.102297","url":null,"abstract":"<div><h3>Objectives</h3><div>The main objective of this study was to investigate self-reported reasons for medication non-adherence among type 2 diabetes mellitus (T2DM) patients in Kelantan.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted among a representative sample of the Kelantanese population of T2DM patients who refilled their medications at government health clinics between April 15th and May 31st, 2025 (<em>n</em> = 458). Medication adherence was measured using the Simplified Medication Adherence Scale (SMAQ). Reasons for medication non-adherence were obtained via a structured interview. Associations between baseline characteristics and low adherence were estimated using the chi-squared test.</div></div><div><h3>Results</h3><div>The survey response rate was 83.2 % (472/566). Three percent (14/472) of respondents were excluded from the analysis due to missing data. The top five reasons for non-adherence were ‘I forgot’ 92.3 % (385/417), ‘I was late for/missed the medication refill appointment at the pharmacy counter’ 31.2 % (130/417), ‘Nobody reminds me to take the medications’ 24.7 % (103/417), ‘There are too many medications to take’ 22.1 % (92/417) and ‘I feel healthy’ 21.6 % (90/417). The prevalence of low adherence was 18.8 % (86/417). Distance from home to clinic &gt;5 km (<em>p</em> = 0.045) and the need for assistance in medication taking (<em>p</em> = 0.035) were significantly associated with low adherence.</div></div><div><h3>Conclusions</h3><div>Our study identified several key reasons for medication non-adherence among patients with T2DM in Kelantan, including forgetfulness, missed refill appointments, lack of reminders, polypharmacy, and the perception of being healthy. Distance to the clinic and reliance on others for medication administration were significantly associated with low adherence. These findings highlight the need for patient-centred interventions that address both behavioural and structural barriers to adherence.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102297"},"PeriodicalIF":1.7,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}