Clinical Epidemiology and Global Health最新文献

{"title":"Unveiling the hidden burden of malnutrition in tuberculosis: A multifaceted evaluation using malnutrition universal screening tool and patient-generated subjective global assessment","authors":"Priyanka Guha ,&nbsp;Meenakshi Abbagouni ,&nbsp;Maturu Ashok ,&nbsp;Rajat Kumar Mishra ,&nbsp;Tukaram Kendre ,&nbsp;Gulshan Singh Rana ,&nbsp;Abhik Sen ,&nbsp;Krishna Pandey ,&nbsp;Sameer Dhingra","doi":"10.1016/j.cegh.2025.102253","DOIUrl":"10.1016/j.cegh.2025.102253","url":null,"abstract":"<div><h3>Problem considered</h3><div>Tuberculosis (TB) remains a significant public health burden, especially in resource-limited countries. Malnutrition is a significant concern among TB patients, exacerbating symptoms and impeding recovery. Despite this, standardised nutritional screening remains underutilised in TB care programs. Accurate and routine nutritional assessment is essential to guide timely interventions and improve treatment outcomes among TB patients. This study aimed to assess malnutrition risk in TB patients using MUST and PG-SGA, evaluate disagreement between screening tools, and determine the limitations of Body Mass Index (BMI) based assessments.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted among 194 adult TB patients receiving anti-TB therapy in Bihar, India. Nutritional risk was evaluated using MUST and PG-SGA, along with demographic, clinical, and anthropometric data. Statistical analyses included ANOVA, Bonferroni post hoc tests, chi-square tests, and Cohen's kappa to assess agreement between tools.</div></div><div><h3>Results</h3><div>The study revealed a high prevalence of malnutrition risk, with MUST detecting 74.2 % and PG-SGA detecting 88.1 % of the overall population. Underweight patients were disproportionately affected, with MUST identifying 96.5 % and PG-SGA identifying 88.3 % as high-risk. This study emphasises the limitations of BMI alone in assessing malnutrition risk and reveals near-random agreement (κ = 0.010, p &lt; 0.001), suggesting BMI alone inadequately captures malnutrition risk in TB patients.</div></div><div><h3>Conclusion</h3><div>This study highlights a critical gap in malnutrition screening for TB patients, with MUST and PG-SGA detecting high but discordant risk levels. Given PG-SGA's higher sensitivity, policymakers in resource-limited settings should consider integrating it into TB programs for early nutritional intervention, while further research validates optimal screening approaches.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102253"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685521","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":"Burden of reproductive cancers in India: Insights from population-based cancer registries","authors":"Ranjan Kumar Prusty ,&nbsp;Varun Kumar Kashyap ,&nbsp;Mahadev Bhise ,&nbsp;Shahina Begum ,&nbsp;Sharyu Mhamane ,&nbsp;Anupama Chauhan","doi":"10.1016/j.cegh.2025.102261","DOIUrl":"10.1016/j.cegh.2025.102261","url":null,"abstract":"<div><h3>Problem considered</h3><div>Reproductive cancers (RCs) are a major component of India's non-communicable disease burden, with significant gender and regional disparities. Despite being largely preventable, early detection and access to care remain limited, and comprehensive national-level incidence data are scarce. The present study aims to provide an overview of the epidemiology of RCs in India, including their magnitude and patterns, based on data from population-based cancer registries.</div></div><div><h3>Methods</h3><div>Cancer incidence data from 37 Population-Based Cancer Registries (PBCRs) in India, covering the years 2012–2017, were analysed. RC cases were identified using ICD-10 codes. Age-standardized incidence rates (ASRs), age-specific rates, and lifetime cumulative risks were computed and disaggregated by sex and region.</div></div><div><h3>Results</h3><div>Among 436,223 total cancer cases, 61,190 (14.0 %) were RCs—15,091 in males (6.9 %) and 46,099 in females (21.3 %). In females, cervical cancer accounted for 48.8 % of RCs, followed by ovarian (28.7 %) and endometrial (15.5 %) cancers. In males, prostate cancer comprised 78.8 % of RC cases. The burden peaked between the ages of 40 and 59 years in both sexes. In India, the lifetime cumulative risk was 1 in 34 for females and 1 in 68 for males, with higher risks observed in northern and southern regions of India.</div></div><div><h3>Conclusion</h3><div>The burden of RCs in India is disproportionately higher among females, with marked regional disparities. Strengthening early detection programmes and leveraging Health and Wellness Centres under Ayushman Bharat are critical strategies. Region-specific, gender-sensitive approaches, coupled with ongoing surveillance and a multisectoral policy focus, are essential to improve outcomes and mitigate the psychosocial impacts of RCs.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102261"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790472","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":"Health literacy, medication adherence, and diabetes complications in Morocco: A cross-sectional study","authors":"Sanaa Mohammi ,&nbsp;Nada Bennani Mechita ,&nbsp;Leila Lafdili ,&nbsp;Majdouline Obtel ,&nbsp;Rachid Razine","doi":"10.1016/j.cegh.2025.102263","DOIUrl":"10.1016/j.cegh.2025.102263","url":null,"abstract":"<div><h3>Background</h3><div>Diabetes is a major public health challenge in Morocco. Health literacy (HL) and medication adherence are central to self-management and complication prevention, yet evidence from primary care is limited.</div></div><div><h3>Objective</h3><div>To assess functional, communicative, and critical HL among adults with diabetes in Marrakech primary care, and examine their associations with medication adherence and self-reported complications.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted among 333 adults with type 1 or type 2 diabetes attending urban and rural primary healthcare facilities. HL was assessed using the French Functional, Communicative, and Critical Health Literacy (FCCHL) scale, and adherence using the 8-item Morisky Medication Adherence Scale (MMAS-8). Sociodemographic and clinical data were collected through interviewer-administered questionnaires. Non-parametric tests, Spearman correlations, and multivariable linear regression examined factors associated with HL, adherence, and complications.</div></div><div><h3>Results</h3><div>Overall HL was moderate (median FCCHL 49, IQR 45–54), with critical literacy the least developed. HL did not differ by age or diabetes type but varied by education, occupation, and insurance. Three-quarters of participants had low or moderate adherence, which correlated positively with functional and critical literacy and negatively with communicative literacy. Diabetes complications were frequent (43.5 %) but showed only weak links with HL.</div></div><div><h3>Conclusion</h3><div>HL domains were differentially associated with adherence, with critical literacy showing the strongest relationship. Education and social position were key predictors of HL, whereas clinical characteristics contributed little. Primary care interventions should target functional and critical HL and adapt communication to patients’ sociodemographic profiles, while longitudinal studies clarify causal pathways linking HL, adherence, and complications.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102263"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790563","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 relationship between spirituality and resilience among families with mental illness in Indonesia","authors":"Faizatur Rohmi ,&nbsp;Arik Agung Setiawan","doi":"10.1016/j.cegh.2025.102192","DOIUrl":"10.1016/j.cegh.2025.102192","url":null,"abstract":"<div><h3>Background</h3><div>Providing long-term home care for mental illness can be detrimental to the physical, mental, social, and spiritual health of the family and can impact family resilience.</div></div><div><h3>Purpose</h3><div>This study aims to identify the relationship between spirituality and resilience among families with mental illness.</div></div><div><h3>Methods</h3><div>This cross-sectional correlation study. Participants consisted of families of mentally illness patients registered with the Malang District Health Service. The inclusion criteria of the respondents, The sampling technique uses purposive sampling. Data were collected using demographic questionnaires, Spiritual Connection Questionnaire: SCQ-48, and Walsh Family Resilience Questionnaire. Pearson's correlation coefficient was applied for data analysis.</div></div><div><h3>Results</h3><div>A total of 125 families with mental illness participated in the study. Mean scores of spirituality, family resilience were 16.33 ± 4.5 and 39.89 ± 10.9. Pearson correlation showed a significant correlation between spirituality and resilience (r = 0.309, P = 0,001).</div></div><div><h3>Conclusion</h3><div>This study revealed that spirituality plays a role as a pillar in building resilience in families caring for people with mental illness, in addition this study revealed that spirituality can enhance healthy coping strategies, especially in uncertain situations when caring for patients.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102192"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737222","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}

{"title":"Role of two-day injectable dexamethasone therapy in the resolution of uncomplicated parapneumonic effusion: A single-blinded randomized trial","authors":"Anshika Mishra ,&nbsp;Shally Awasthi","doi":"10.1016/j.cegh.2025.102266","DOIUrl":"10.1016/j.cegh.2025.102266","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the effect of two days of intravenous dexamethasone therapy on the resolution of uncomplicated parapneumonic effusion in hospitalized children aged 1 month to 14 years, as measured by <strong>standardized pleural fluid volume estimation on bedside ultrasonography (posterior axillary and interscapular views, using Eibenberger's formula) on days 3</strong>–<strong>4 of admission.</strong></div></div><div><h3>Methods</h3><div>This single-center, randomized, single-blind, parallel-group clinical trial included 62 children diagnosed with community-acquired pneumonia (CAP) and pleural effusion. Participants were randomized into two groups: the intervention group received intravenous dexamethasone (0.25 mg/kg/dose) four times daily for two days along with antibiotics and usual care, while the control group received only antibiotics and usual care. The primary outcome was the resolution of pleural effusion based on ultrasonographic volume. <strong>Secondary outcomes included changes in inflammatory markers, hospital length of stay, need for pleural intervention, and adverse events.</strong></div></div><div><h3>Results</h3><div>All 62 patients (mean age 2 years; 61.3 % male) completed the study. In the intervention group, the mean pleural fluid volume decreased significantly from 13.97 ± 6.61 ml on admission to 3.22 ± 3.99 ml by day 4. In contrast, the control group showed an increase from 15 ± 7.53 ml to 17.07 ± 12.36 ml (p &lt; 0.001). The intervention group also showed a significant reduction in C-reactive protein (CRP) and total leukocyte count compared to controls (p &lt; 0.001). <strong>Mean hospital stay was significantly shorter in the dexamethasone group (5.8 ± 1.2 vs 7.3 ± 1.6 days, p = 0.01). None of the patients required pleural drainage.</strong> Multivariate linear regression identified dexamethasone intervention as the only significant predictor of effusion resolution (p = 0.0001). No significant differences in complications or adverse events were observed between groups.</div></div><div><h3>Conclusion</h3><div>Short-course intravenous dexamethasone therapy significantly accelerates the resolution of uncomplicated parapneumonic effusion in children without increasing adverse effects. <strong>It also reduces hospital stay without increasing the need for drainage and may serve as a safe and effective adjunct to standard antibiotic therapy in pediatric patients with CAP-associated effusion.</strong></div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102266"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839876","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":"Predicting severity in spotted fever in India: A retrospective cohort study","authors":"Nitin Gupta ,&nbsp;Praveen Kumar Tirlangi ,&nbsp;Rachana Bhat ,&nbsp;S. Chaithra ,&nbsp;Mohammad Arham Parvez ,&nbsp;V. Shashidhar ,&nbsp;Seema Shetty ,&nbsp;Muralidhar Varma ,&nbsp;K.E. Vandana ,&nbsp;Prithvishree Ravindra","doi":"10.1016/j.cegh.2025.102255","DOIUrl":"10.1016/j.cegh.2025.102255","url":null,"abstract":"<div><h3>Problem considered</h3><div>Spotted fever, a neglected rickettsial illness in India, can present with life-threatening complications, yet early predictors of severity remain poorly defined.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of 117 adult patients with spotted fever admitted to a tertiary care centre in Karnataka, India (2017–2024). Spotted fever was diagnosed based on a positive Weil-Felix test (OX-2 and/or OX-19) with exclusion of other common tropical infections. Severe disease was defined as the presence of oxygen requirement, vasopressor use, dialysis, or altered sensorium. Clinical and laboratory variables were compared between severe and non-severe groups, and multivariable logistic regression identified independent predictors.</div></div><div><h3>Results</h3><div>Severe disease occurred in 31.6 % (37/117). On multivariable analysis, <strong>shorter duration of illness at presentation to the hospital</strong> was independently associated with severe disease <strong>[aOR 0.70 (95 % CI: 0.57</strong>–<strong>0.86)]</strong>, while <strong>higher serum creatinine</strong> also predicted severity <strong>[aOR 1.29 (95 % CI: 1.00</strong>–<strong>1.66)]</strong>. <strong>Lower serum albumin</strong> showed a strong association with severe disease <strong>[aOR 0.16 (95 % CI: 0.07</strong>–<strong>0.37)]</strong>. Although platelet count demonstrated an inverse trend, the association did not reach statistical significance <strong>[aOR 0.92 (95 % CI: 0.83</strong>–<strong>1.03)]</strong>. The model showed good calibration (Hosmer–Lemeshow p = 0.128) and an overall accuracy of 77.7 %.</div></div><div><h3>Conclusion</h3><div>In spotted fever, simple and accessible markers, shorter illness duration, renal dysfunction, and hypoalbuminemia, can help predict severity and guide early referral, especially in resource-limited settings. These findings merit validation in prospective cohorts.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102255"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685519","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":"Effectiveness of mHealth interventions for improving diabetes management outcomes in patients with type 2 diabetes: A cluster randomized crossover trial in Western Rajasthan","authors":"Ramesh Kumar Huda,&nbsp;Jayvardhan Singh,&nbsp;Pankaj Kumar,&nbsp;Laxmikant Mandhana,&nbsp;Manoj Kumar,&nbsp;Ramesh Kumar Sangwan,&nbsp;Bontha V. Babu","doi":"10.1016/j.cegh.2025.102264","DOIUrl":"10.1016/j.cegh.2025.102264","url":null,"abstract":"<div><h3>Problem considered</h3><div>Type 2 diabetes (T2DM) poses a major public health challenge in India, particularly in Western Rajasthan, where access to consistent diabetes care is limited. Despite national programs, management gaps persist. mHealth interventions offer scalable, low-cost solutions, but evidence from Indian primary care settings remains limited.</div></div><div><h3>Methods</h3><div>This cluster-randomized crossover trial was conducted between January and November 2024 across two urban Primary Health Centres (PHCs) in Jodhpur, Rajasthan. One PHC (n = 140) received an mHealth intervention (SMS and Android app reminders) with usual care, while the other (n = 140) received usual care alone. The primary outcome was the change in HbA1c, quality of life, and other health outcomes at 6 months, analyzed using paired and independent t-tests.</div></div><div><h3>Results</h3><div>Finding shows, the intervention group showed significant improvements: mean HbA1c decreased from 9.23 % to 8.33 % (p &lt; 0.001), BMI from 27.25 to 26.74 kg/m² (p &lt; 0.05), systolic BP from 138 to 132 mmHg (p &lt; 0.01), diastolic BP from 86 to 84 mmHg (p &lt; 0.05), and quality of life improved (p = 0.001). The control group demonstrated a significant reduction in mean HbA1c (8.96 %–7.70 %, p &lt; 0.001), but no improvement in anthropometric measures, and a significant decline in quality of life (p = 0.001).</div></div><div><h3>Conclusions</h3><div>The study concluded that mHealth intervention significantly improved glycemic control, blood pressure, waist circumference, and quality of life, highlighting its potential as an effective tool for diabetes self-management in resource-limited settings.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102264"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790474","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}