Clinical Epidemiology and Global Health最新文献

{"title":"Survival analysis of syphilis infection in pregnant women of Papuan and non-Papuan ethnicities in Jayapura City and Regency, Papua, Indonesia","authors":"Mona Safitri Fatiah ,&nbsp;Yane Tambing ,&nbsp;Sarni Rante Allo Bela ,&nbsp;Titi Iswanti Afelya ,&nbsp;Genoveva C.C. Mollet ,&nbsp;Wilma Florensia ,&nbsp;Apriyana Irjayanti ,&nbsp;Maxsi Irmanto ,&nbsp;Ilmidin","doi":"10.1016/j.cegh.2025.102278","DOIUrl":"10.1016/j.cegh.2025.102278","url":null,"abstract":"<div><h3>Problem considered</h3><div>In Papua, Indonesia, syphilis in pregnancy persists as a public health concern, yet the role of ethnicity and culture in infection risk is poorly understood.</div></div><div><h3>Methods</h3><div>We conducted a prospective cohort study with an embedded mixed-methods design among 977 pregnant women attending their first Antenatal Care (ANC) visits across 15 health centers in Jayapura City and Regency (July 2025–August 2025).</div></div><div><h3>Results</h3><div>the overall cumulative incidence of syphilis during pregnancy was 11.7 %, differing significantly by ethnicity—13.8 % among Papuan women and 8.7 % among non-Papuan women (log-rank p = 0.03). Papuan women exhibited a higher syphilis risk compared to non-Papuans (AHR = 1.43; 95 % CI: 0.98–2.08), associated with cultural taboos against premarital pregnancy. Additional risk factors included unmarried status (AHR = 1.78; 95 % CI: 1.34–2.36), hepatitis B coinfection (AHR = 2.33; 95 % CI: 1.31–4.16), inconsistent condom use, and uncircumcised partners. Kaplan–Meier curves showed a steep decline in syphilis-free probability during the second and third trimesters. Qualitative insights underscored the influence of stigma, gendered sexual decision-making, and reliance on ANC for diagnosis and treatment.</div></div><div><h3>Conclusion</h3><div>Maternal syphilis in Jayapura is influenced by intertwined biological, behavioral, and socio-cultural factors. Targeted, culturally sensitive interventions, enhanced ANC utilization, integrated STI/Hepatitis services, and promotion of safe sexual practices are essential to reduce incidence and support elimination efforts.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102278"},"PeriodicalIF":1.7,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980502","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":"LDL-cholesterol goal achievement and guideline adherence among middle-to older-age Irish adults in a primary care setting","authors":"Rehab Elhiny ,&nbsp;Linda M. O'Keeffe ,&nbsp;Seán R. Millar ,&nbsp;Stephen Byrne ,&nbsp;Margaret Bermingham ,&nbsp;Maria Donovan","doi":"10.1016/j.cegh.2026.102286","DOIUrl":"10.1016/j.cegh.2026.102286","url":null,"abstract":"<div><h3>Background</h3><div>A significant gap exists between recommended low-density lipoprotein cholesterol (LDL-C) treatment goals and the achievement of these goals in clinical practice. In addition, there remains suboptimal utilization of lipid-lowering therapies (LLT). This study examines the prescribing pattern of LLT and the level of LDL-C goal achievement among Irish adults in a primary care setting. In addition, it identifies patient factors associated with the prescribing of LLT and LDL-C goal achievement.</div></div><div><h3>Methods</h3><div>This was a cross-sectional analysis of rescreen data from the Mitchelstown Cohort Study. Demographic, medication and diagnosis data were obtained from participant electronic health records. Cardiovascular risk was assessed using the SCORE tool. LDL-C goal achievement was determined using the LDL-C goals set out in the 2011 ESC/EAS guidelines for the management of dyslipidemia.</div></div><div><h3>Results</h3><div>Among 1183 participants (median age = 65 years), 48.5 % were prescribed LLT, 42 % of whom attained their LDL-C goal. Only 17.5 % were prescribed high-intensity statin therapy and 13 % were prescribed combination therapy. In multivariable analysis, diabetes history, polypharmacy, and hyper-polypharmacy were associated with prescribing LLT. Being male or ≤59 years of age was associated with lower likelihood of LLT prescription. Target LDL-C goal achievement was associated with male sex and age ≤64 or ≥70 years, while BMI 25–29 kg/m² was associated with lower LDL-C goal achievement.</div></div><div><h3>Conclusion</h3><div>Dyslipidemia is undertreated in this Irish primary care population with limited use of high-intensity statins. This study highlights the gap between guideline recommendations for LLT prescription and LDL-C target goals and real-world implementation of guidelines.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102286"},"PeriodicalIF":1.7,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980501","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":"Identification of health educational needs of women in a vulnerable region","authors":"Juan Guillermo Barrientos Gómez ,&nbsp;Sara Arango Valencia ,&nbsp;María Camila Gómez Ramírez ,&nbsp;Juliana Builes Moncada ,&nbsp;Angela Maria Echeverry","doi":"10.1016/j.cegh.2025.102279","DOIUrl":"10.1016/j.cegh.2025.102279","url":null,"abstract":"<div><h3>Introduction</h3><div>Education to promote women's health must be continuous and adapted to the changing needs of each stage of the life cycle.</div></div><div><h3>Objective</h3><div>To identify and describe the health training needs of women attending primary care centers in a Colombian subregion.</div></div><div><h3>Methods</h3><div>Descriptive cross-sectional study conducted among women aged 18–44 years attending four primary care centers. After informed consent, participants completed an online questionnaire assessing knowledge according to life-cycle stage: non-pregnant, pregnant, or postpartum. Descriptive analyses were performed, and differences across groups were evaluated using ANOVA and bivariate analyses. Multivariate logistic regression identified determinants of performance.</div></div><div><h3>Results</h3><div>A total of 1478 women participated (612 non-pregnant, 454 pregnant, 412 postpartum), with a median age of 26 years; 90.4 % had low socioeconomic status and 82.8 % low educational attainment. Educational needs varied by life-cycle stage: non-pregnant women required training in contraception, menstrual cycle, STIs, cancer screening, and mental health; pregnant women in vaccination and sexuality; postpartum women in depression, puerperal care, childcare, breastfeeding, and newborn vomiting. Knowledge scores differed significantly (p &lt; 0.001): pregnant women scored highest (73.33 %), followed by postpartum (57.57 %) and non-pregnant participants (52.83 %). Differences by educational level were evident. In the non-pregnant group, scores increased from 45.28 % (no schooling) to 56.60 % (secondary education). Pregnant women showed the strongest gradient, rising from 51.67 % to 80.00 % from no schooling to higher education. Among postpartum women, scores were lowest with no schooling (30.30 %) and stabilized between 54 and 59 % for all educated groups. Regression analysis identified education and municipality of residence as main determinants of performance. Higher education substantially reduced failure probability (OR: 0.16), whereas age increased it slightly (OR: 1.04). Stratified models showed highest predictive capacity among pregnant women (AUC: 0.74). The postpartum model performed poorly (AUC: 0.61).</div></div><div><h3>Conclusion</h3><div>Educational needs differ across the life cycle and are strongly shaped by schooling. Tailored, stage-specific strategies that consider educational level and local context may strengthen maternal and reproductive health knowledge and improve outcomes for women and their children.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102279"},"PeriodicalIF":1.7,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146190011","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":"Assessing the hotspot analysis and spatial clustering for pulmonary tuberculosis from 2019 to 2023 in Mysuru district, India","authors":"Suhail Azam Khan ,&nbsp;M.C. Manjunatha ,&nbsp;B.S. Jayaraj ,&nbsp;S.K. Chaya ,&nbsp;K.S. Lokesh ,&nbsp;Mohammad Shiraz Ahmed ,&nbsp;P.A. Mahesh","doi":"10.1016/j.cegh.2025.102272","DOIUrl":"10.1016/j.cegh.2025.102272","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary Tuberculosis (PTB) remains a major cause of morbidity in India despite progress in TB elimination, accounting for roughly 25 % of global TB cases. Ongoing spatial and demographic disparities hinder further reduction. The study aims to assess PTB syndemic profiles, spatial distribution, and persistent hotspots in a high-burden Indian district from 2019 to 2023 using geospatial analytics to inform precision public health policies.</div></div><div><h3>Methods</h3><div>A retrospective cross-section analysis of 10,201 PTB cases in Mysuru district used ArcGIS and Google Earth Pro to examine point density by age, gender, HIV status, and diabetes. Spatial autocorrelation (Moran's I, Getis-Ord Gi∗) identified hotspot clusters, while chi-square tests evaluated demographics and comorbidity trends.</div></div><div><h3>Results</h3><div>Between 2019 and 2023, PTB cases declined by 7.7 % (from 2245 to 2029). Cases among individuals aged 0–18 and 19–44 fell by 22 % and 22.3 %, respectively. Both male and female cases dropped by about 9.5 %, while diabetes cases rose by 10 % and non-diabetes cases fell by 6.5 %. HIV-positive cases declined by 52.6 %. A Moran's Index of 0.381799, z-score of 31.45, and p-value &lt;0.001 indicate strong, statistically significant spatial clustering.</div></div><div><h3>Conclusion</h3><div>Despite the overall decline in disease burden, persistent urban PTB clusters continue to affect the elderly and individuals with diabetes. While TB-HIV comorbidity has significantly decreased, the enduring Diabetes-TB overlap highlights the need for integrated, geospatially targeted interventions and continuous GIS-based surveillance to address high-risk clusters and advance TB elimination in urban areas.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102272"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883501","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":"Intersecting cultural beliefs and structural barriers: Healthcare-Seeking for buruli ulcer in Imo State, Nigeria","authors":"Chigozie Divine Onwuka ,&nbsp;Evangeline Tochi Oparaocha","doi":"10.1016/j.cegh.2025.102283","DOIUrl":"10.1016/j.cegh.2025.102283","url":null,"abstract":"<div><h3>Problem</h3><div>Buruli ulcer (BU), caused by <em>Mycobacterium ulcerans</em>, is a neglected tropical disease endemic to parts of Nigeria. Despite its public health impact, healthcare-seeking behavior in rural communities’ remains poorly understood, limiting targeted interventions.</div></div><div><h3>Methods</h3><div>A cross-sectional mixed-methods study was conducted in four endemic LGAs of Imo State. Quantitative data were collected from 300 respondents using structured questionnaires, while qualitative data were generated through 30 in-depth interviews with patients and caregivers, 12 interviews with traditional healers, 9 key informant interviews with health workers, and 7 focus group discussions. Quantitative analysis employed descriptive statistics and logistic regression, while qualitative transcripts were analyzed thematically using the Socio-Ecological Model</div></div><div><h3>Results</h3><div>Only 27.4 % of respondents sought biomedical care within two weeks of symptom onset, while 34.7 % consulted traditional healers first. Delayed hospital presentation was associated with low education (AOR = 2.14; 95 % CI: 1.4–3.8), belief in spiritual causation (AOR = 1.88; 95 % CI: 1.1–3.3), residing more than 5 km from the nearest health facility (AOR = 1.76; 95 % CI: 1.5–4.5), and lack of health insurance (AOR = 1.54; 95 % CI: 1.1–2.8). Qualitative data revealed spiritual interpretations, poverty, gender inequities, stigma, and mistrust of health facilities as barriers</div></div><div><h3>Conclusion</h3><div>Healthcare-seeking for BU in Imo State is constrained by the intersection of cultural beliefs and structural barriers. Interventions should combine culturally sensitive education, stigma reduction, financial protection, and decentralized service delivery to improve timely access to care.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102283"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925035","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 associated with lymphatic filariasis in Indonesia","authors":"Sinta Dewi Lestyoningrum ,&nbsp;Adistha Eka Noveyani ,&nbsp;Debri Rizki Faisal ,&nbsp;Wahyu Pudji Nugraheni ,&nbsp;Syarifah Nuraini ,&nbsp;Indah Pawitaningtyas ,&nbsp;Linta Meyla Putri","doi":"10.1016/j.cegh.2025.102277","DOIUrl":"10.1016/j.cegh.2025.102277","url":null,"abstract":"<div><h3>Problem considered</h3><div>Lymphatic filariasis (LF) remains a significant public health issue in Indonesia despite global progress and national elimination efforts. This study aimed to comprehensively assess the influence of socioeconomic characteristics, preventive behaviors, and housing environmental factors on the risk of LF among Indonesian adults.</div></div><div><h3>Methods</h3><div>This cross-sectional study used the 2023 Indonesia Health Survey to examine associations between socioeconomic factors, protective behaviors, housing characteristics, and lymphatic filariasis (LF) among 570,618 adults. Associations with LF were analyzed using multivariable logistic regression, with results reported as adjusted odds ratios (AORs) and 95 % confidence intervals.</div></div><div><h3>Results</h3><div>The prevalence of LF was 0.14 %. Socio-demographic characteristics (age, sex, education, wealth index, and residence) were not statistically associated with LF risk. However, regular use of mosquito repellents (sprays, coils, electric devices) was significantly associated with a 25 % reduction in LF risk (AOR 0.75, 95 % CI: 0.59–0.95). Living in houses with non-permanent roofing (AOR 1.49, 95 % CI: 0.97–2.28) and without ceilings (AOR 1.20, 95 % CI: 0.93–1.54) showed increased, though non-significant, odds of LF occurrence.</div></div><div><h3>Conclusion</h3><div>LF risk in Indonesia is not distinguished by socioeconomic status but is more strongly determined by consistent adoption of protective behaviors and housing quality. Universal access to mosquito repellents and targeted improvement in housing infrastructure should be prioritized as equitable and effective LF control strategies.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102277"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883500","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":"Tranexamic acid in bleeding management of advanced cancer in palliative care: A systematic review","authors":"Ian Huang ,&nbsp;Dion Ravinder Theodeus Subroto ,&nbsp;Felicia Nathania Kosasih ,&nbsp;Stephen Tjandra ,&nbsp;Darien Alfa Cipta","doi":"10.1016/j.cegh.2025.102274","DOIUrl":"10.1016/j.cegh.2025.102274","url":null,"abstract":"<div><h3>Problem considered</h3><div>Bleeding complications in patients with advanced cancer receiving palliative care pose a significant clinical challenge. Tranexamic acid (TXA) has been explored as a potential therapeutic option for bleeding control. This review aimed to summarize the evidence on TXA, with a primary focus on the efficacy and safety profile of TXA in addressing bleeding issues in advanced cancer patients within palliative care.</div></div><div><h3>Methods</h3><div>A systematic literature search using relevant keywords was conducted in medical databases, including PubMed, EBSCO, Google Scholar and Cochrane Central Library, from inception to September 14th, 2023. Randomized controlled trials (RCTs), observational studies, and case series or case reports that evaluated the use of TXA in advanced cancer patients for bleeding management in palliative care settings were included.</div></div><div><h3>Results</h3><div>A total of eleven studies were included, comprising one observational study, one non-randomized study, six case reports, and three case series. Among the advanced cancer patients, the majority (87 %) had solid tumors. The overall success rate for bleeding cessation was 91.3 %, with a median of 3 days (ranging 15 min to 30 days) to achieve complete bleeding cessation. All routes of TXA administration with varying dosages were documented, including subcutaneous (46.5 %), oral (23.3 %), intravenous (18.6 %), and topical (11.6 %). Thromboembolic events were observed in 4.3 % of patients. No RCTs were identified during our search.</div></div><div><h3>Conclusion</h3><div>Tranexamic acid appears to be an effective and well-tolerated option for managing bleeding in advanced cancer patients receiving palliative care. Further research is needed to establish optimal dosing regimens and confirm its safety.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102274"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883583","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":"Determinants of permanent contraceptive use among multiparous women in Indonesia: The role of education and other demographic factors","authors":"Maya Fitria ,&nbsp;Agung Dwi Laksono ,&nbsp;Isyatun Mardhiyah Syahri ,&nbsp;Ratna Dwi Wulandari ,&nbsp;Yuly Astuti ,&nbsp;Ratu Matahari ,&nbsp;Purwo Setiyo Nugroho","doi":"10.1016/j.cegh.2025.102280","DOIUrl":"10.1016/j.cegh.2025.102280","url":null,"abstract":"<div><h3>Problem considered</h3><div>Increased education for women, in line with their increased independence in making decisions for their good. The study analyzed the role of education and demographic factors in permanent contraceptive use among multiparous women in Indonesia.</div></div><div><h3>Methods</h3><div>This cross-sectional study examined 33,471 respondents. We used permanent contraceptives as an outcome variable and education level as an exposure variable. The study also uses nine control variables (residence, age, partner, employment, wealth, family planning (FP) information exposure from the radio, television, and the internet, and the number of living children). The study used binary logistic regression to assess the association between education level and the use of permanent contraceptives, adjusting for relevant control variables.</div></div><div><h3>Results</h3><div>The results showed that the average permanent contraceptive use among multiparous women in Indonesia is 78.7 %. Primary education was 1.747 times more likely than no formal education to use permanent contraceptives (AOR 1.747; 95 % CI 1.458–2.092). Meanwhile, secondary education was 3.295 times more likely to use permanent contraceptives than no formal education (AOR 3.295; 95 % CI 2.720–3.991). Moreover, higher education was 5.360 times more likely than no formal education to utilize permanent contraceptives (AOR 5.360; 95 % CI 4.227–6.796).</div></div><div><h3>Conclusions</h3><div>The study concluded that education level was associated with permanent contraceptive use among multiparous women in Indonesia. The higher the education level, the higher the possibility of using permanent contraceptives. Moreover, the study also found all control variables associated with permanent contraceptive use among multiparous women in Indonesia.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102280"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925032","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":"Associated factors for low modern contraceptive use and high unmet needs among postpartum women in Nepal: A cross-sectional study","authors":"Gita Shrestha,&nbsp;Minato Nakazawa","doi":"10.1016/j.cegh.2025.102281","DOIUrl":"10.1016/j.cegh.2025.102281","url":null,"abstract":"<div><h3>Problem considered</h3><div>Postpartum family planning (PPFP) plays a crucial role in reducing unintended pregnancies. However, many low-resource countries, including Nepal, have limited uptake of modern contraceptives. This study assessed PPFP use and unmet contraceptive needs among women within six months postpartum and identified factors associated with it.</div></div><div><h3>Methods</h3><div>This was a cross-sectional study. Of the 33 healthcare facilities screened, eight met the inclusion criteria. A total of 241 women who provided consent were enrolled in the study. Descriptive analyses were conducted using Jamovi version 2.6.2.0, and multivariate logistic regression was performed in R version 4.4.2 to identify predictors of modern contraceptive use. Odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated, with statistical significance set at p &lt; 0.05.</div></div><div><h3>Result</h3><div>Logistic regression revealed key predictors of modern family planning: higher parity (OR = 2.55, 95 % CI: 1.02–6.39, p = 0.045), knowledge of ovulation (OR = 3.20, 95 % CI: 1.03–9.88, p = 0.043), and past family planning (FP) use (OR = 4.57, 95 % CI: 1.86–11.22, p &lt; 0.001) were significantly associated with modern contraceptive use. Conversely, having a last child under two years (OR = 0.49, 95 % CI: 0.25–0.98, p = 0.043) was associated with a negative outcome.</div></div><div><h3>Conclusion</h3><div>Almost two-thirds of the women wish to delay or prevent a future pregnancy, and one in six women adopted modern contraceptives within six months postpartum. Interventions aimed at increasing the adoption of effective contraceptive methods are urgently needed to reduce unmet needs and improve maternal and child health outcomes.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102281"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925033","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":"Optimizing predictive analytics for childhood anaemia: A machine learning model approach","authors":"Baby Das ,&nbsp;Manash Pratim Barman ,&nbsp;Manas Jyoti Kotoky","doi":"10.1016/j.cegh.2025.102275","DOIUrl":"10.1016/j.cegh.2025.102275","url":null,"abstract":"<div><h3>Problem considered</h3><div>Anaemia remains a prevalent public health concern, particularly among children under five, with multifactorial causes including nutritional deficiencies, maternal health, and socioeconomic status. This study aims to enhance the prediction and understanding of childhood anaemia of Assam, India using machine learning (ML) techniques.</div></div><div><h3>Methods</h3><div>Using data from the National Family Health Survey-5 (NFHS-5) in Assam, India, a total of 8411 children were analyzed. Ten key predictors were identified using the Boruta algorithm and chi-square tests. Due to class imbalance, the dataset was balanced using Synthetic Minority Over-sampling Technique for Nominal and Continuous (SMOTE-NC). Four supervised ML models Logistic Regression, Random Forest, K-Nearest Neighbors (KNN), and Gradient Boosting were trained and evaluated using k-fold cross-validation.</div></div><div><h3>Result</h3><div>Gradient Boosting outperformed other models, achieving an accuracy of 77.2 %, precision of 79.2 %, recall of 77.2 %, F1-score of 76.7 %, and AUC value of 0.83 after balancing. Model interpretability was achieved by using an explainable AI tool i.e. SHAP (SHapley Additive exPlanations), which revealed that environmental, socio-economic and maternal factors such as roof and floor material, child's age, mother's anaemia level, and place of de-livery (Home/Public sector) significantly influenced anaemia risk.</div></div><div><h3>Conclusion</h3><div>The study demonstrates the effectiveness of ML in not only predicting anaemia with high accuracy but also uncovering actionable risk factors for public health interventions. It highlights the need for data-driven approaches in addressing childhood anaemia, especially in low-resource settings.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102275"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883498","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}