Journal of Global Health最新文献

Humans have developed sensory organs for their 'major' senses and specific neuronal receptors for a number of additional senses. Although information from sensors is integrated and processed in the brain, the brain itself has not been proposed as a sensory organ associated with a particular sense - at least not in Western culture or scientific literature. Perception of ideas has many elements of a separate sense, with the brain being a primary sensory organ. I support this notion based on 17 years of experience in the application of the Child Health and Nutrition Research Initiative (CHNRI) method for setting research priorities, which resulted in more than 150 publications involving thousands of experts who prioritised more than 20 000 research ideas. This body of work allows for the generalisation of the following key concepts: defining an idea in the context of the brain's sensory perception; defining the point of origin, sensory qualities, and common types of ideas; considering responses of the body to the brain's sensory exposure to ideas; and defining the key criteria that the brain uses to discriminate between and prioritise ideas. The human brain is continuously being exposed to ideas, which can be self-generated, triggered by information from other sensors, or introduced from the external world. From the brain's sensory perspective, ideas are competing possibilities of purposeful activities that, if followed, would be expected to result in an alternative version of the future. Pursuing ideas tends to drive most of human activity. It requires prioritising between short-, mid-, and long-term investment of energy and time. The brain's sensory role is to continuously assess many competing ideas and prioritise between them based on motivational/emotional ('attractiveness'), operational/rational ('feasibility') and outcome-related perspective ('impact'). Exposure to new ideas may instigate physiological and psychological responses, ranging from enthusiasm and excitement to feeling a threat or fear. Ideas can be used to mobilise large groups of people whose brains respond with excessive enthusiasm that can sometimes be fanatical. The judgment on the attractiveness, feasibility, and potential impact of ideas is affected by education, experience, and cognitive abilities. This sense may be sharpened through an increased level of expert knowledge and experience. Misinformation and disinformation are dangerous because they affect the brain's perception of ideas. Impairment of this inherent sense may perhaps contribute to some mental health issues. The proposed view of the brain as the sensor of ideas could lead to many qualitative or quantitative experiments to further explore the properties of this sense in both individuals and populations, establishing 'the science of ideas'.

Background: An effective health management information system plays a pivotal role in evidence-based decision-making and strengthening health service delivery in a country. The Directorate General of Health Services and the Directorate General of Family Planning of Bangladesh have adopted digital health management information system platforms named district health information system and management information system, respectively. Despite its significance, health management information system data has numerous issues, such as missing values, inaccuracies, lack of internal consistency, and the presence of outliers. This study aims to assess the data quality of reproductive health indicators in the health management information system of the Directorate General of Health Services and the Directorate General of Family Planning.

Methods: The study examined two aspects of data quality: a) completeness of data, subdivided into completeness of facility reporting (report submission rate) and completeness of indicator data (presence of missing values); b) internal consistency of reported data, subdivided into presence of outliers, inter-indicator consistency, and consistency between reported data and original records (accuracy rate). The study utilised retrospective monthly data gathered from July 2021 to June 2022, covering 21 reproductive health indicators. Multi-stage cluster sampling was employed to select 112 health facilities for data collection, including 48 facilities from Directorate General of Health Services and 64 from Directorate General of Family Planning, representing various administrative levels across the country.

Result: The report submission rate for Directorate General of Health Services facilities was 98%, while for the Directorate General of Family Planning facilities, it was 86%. However, 35% of data points were missing in the district health information system server of Directorate General of Health Services, whereas no missing values were observed in the management information system server of Directorate General of Family Planning. Less than 3% of outliers were detected in the server data of both directorates. Inter-indicator consistency was maintained at a high rate of 98% in health facilities under both directorates. The accuracy of reported data varied across indicators and facility types: Directorate General of Health Services facilities showed accuracy rates ranging between 75 and 92%, with an aggregated rate of 86%. Different tiers of the Directorate General of Family Planning facilities had accuracy rates ranging from 92 to 96%.

Conclusion: This research emphasises the significance of rectifying missing values, ensuring consistency, and improving reporting systems, with a particular focus on lower-tier health facilities, to enhance the validity and reliability of reproductive health data in Bangladesh.

Background: Oral rehydration solution (ORS) is crucial in the management of diarrhoea. Until the early 2000s, the standard formulation of glucose-based ORS with a total osmolarity of 311 mmol/L was being used for this purpose. However, due to concerns about sodium levels and cases of hypernatremia, a low-osmolarity ORS solution (LORS) with an osmolarity of 245mmol/L or less was developed to replace the standard ORS. With this systematic review, we aimed to assess the effectiveness of LORS compared to standard ORS for the treatment of acute and persistent diarrhoea.

Methods: We comprehensively searched PubMed, CINAHL, the Cochrane Library, ClinicalTrials.gov, the World Health Organization (WHO) International Clinical Trials Registry Platform, and Scopus until 20 July 2023 for studies published after 1990 assessing the efficacy of LORS in acute and persistent diarrhoea in children under 10 years of age. Meta-analysis was conducted using the RevMan software. We performed log approximation for all the values for an outcome when studies reported arithmetic and geometric means per the Cochrane Handbook. We otherwise used the Cochrane Risk of Bias II tool to assess the risk of bias in individual studies, and assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluations approach. This review was commissioned by the WHO for revision of guidelines for childhood diarrhoea.

Results: For the comparison of LORS to standard ORS in acute diarrhoea, our findings suggest that there was a significant decrease in the duration of diarrhoea (mean difference (MD) = -0.28; 95% confidence interval (CI) = -0.41, -0.15; moderate certainty of evidence), stool output (MD = -0.25; 95% CI = -0.35, -0.16; very low certainty of evidence), and ORS intake (MD = -0.18; 95% CI = -0.28, -0.07; moderate certainty of evidence) in patients receiving LORS. There was a comparable effect on the number of patients cured within five days, treatment failure, and frequency of unscheduled intravenous therapy (risk ratio (RR) = 0.77; 95% CI = 0.72, 9.38; low certainty of evidence). For persistent diarrhoea, there was a significant decrease in duration of diarrhoea (MD = -30.60; 95% CI = -48.95, -12.25), stool output (MD = -14.00; 95% CI = -26.63, -1.37), and ORS intake (MD = -21.40; 95% CI = -41.01, -1.79), while there was a comparable effect on the number of patients cured.

Conclusion: Our findings suggest that LORS should continue to be recommended in children under the age of 10 years with acute watery or persistent diarrhoea and upholds the current WHO recommendations.

Registration: PROSPERO: CRD42023438762.

Background: Links between early life exposures and child development later in life are not sufficiently explored in low- and middle-income countries. We studied associations between sociodemographic variables, growth and development at six to eight months with developmental outcomes at eight years.

Methods: We used data from a maternal education trial which included 511 mother-infant pairs at children's age of six to eight months (baseline). In this follow-up study, data from 361 mother-child pairs were available. Questionnaires were used to collect sociodemographic variables. Growth (anthropometry) was measured by study personnel and converted to z-scores according to the World Health Organization (WHO) growth reference. Child development (cognitive, motor and language) at baseline was assessed using Bayley Scales of Infant and Todler Development, third edition (BSID-III). Development at eight years was measured using two neuropsychological tools: Kaufman Assessment Battery for Children Second Edition (KABC-II) and Test of Variables of Attention (TOVA).

Results: Higher weight-for-age z-scores (adjusted odds ratio (aOR) = 0.74; 95% confidence interval (CI) = 0.53, 0.98; P = 0.04), better maternal education (aOR = 0.86; 95% CI = 0.78, 0.96; P = 0.03). and better household head education (aOR = 0.86; 95% CI = 0.78, 0.96; P = 0.03) at six to eight months of age were associated with lower odds of scoring below average on KABC-II categorical scores at eight years of age. Motor composite scores and maternal parity at six to eight months of age were positively associated with auditory and visual TOVA scores (all P-values <0.05) at eight years. Cognitive composite scores at six to eight months of age were positively associated with visual TOVA scores (P < 0.05). In contrast, weight-for-length z-scores and household head age were negatively associated with both auditory and visual TOVA scores (P < 0.05). Being a female child was associated with lower auditory and visual TOVA scores (P < 0.05).

Conclusions: At six to eight months of age, growth and development, gender, maternal education and parity, and household head age and education were associated with child development at eight years. Interventions emphasising improved growth and development in infancy, as well as parental educational attainment, may improve long-term developmental outcomes.

This corrects the article DOI: 10.7189/jogh.14.04110.

Background: Both Borrelia burgdorferi (Bb) and Anaplasma phagocytophilum (Ap) can infect humans and animals through tick-borne transmission, resulting in zoonosis. Under certain conditions, human infection can lead to Lyme disease (LD) and human granulocytosis (HGA), whereas infection in animals can cause various acute and non-specific symptoms. The combination of Bb and Ap has been reported to increase the disease severity in infected animals. In this systematic review and meta-analysis, we investigated the global diversity of Bb and Ap coinfection in animals and their prevalence and distribution regarding spatial and species ecoepidemiology.

Methods: We queried PubMed, Web of Science, Embase, and the Cochrane Library for original studies on Bb and Ap coinfection. We assessed the rate of Bb and Ap in all included articles by single-group meta-analysis and subgroup analyses. We evaluated publication bias using a combination of funnel plots, Egger's tests, and Begg's tests, and conducted risk of bias assessment using the SYRCLE tool.

Results: Our search retrieved 40 articles, with eight involving 8419 infected animals meeting our inclusion criteria. The SYRCLE bias risk assessment indicated that most of the included studies were of high quality. Forest maps showed that the combined Bb and Ap infection rate in animals worldwide was 5.5% (95% confidence interval (CI) = 2.4-9.6). Subgroup analysis of forest maps showed that the coinfection rates were 8.2% (95% CI = 2.2-17.2) in North American, 0.2% (95% CI = 0.1-0.7) in European, and 1.2% (95% CI = 0.8-1.8) in Asian animals. Coinfection rates were 6.7% (95% CI = 2.7-12.2) in domestic and 0.0% (95% CI = 0.0-0.4) in wild animals. The coinfection rates were 9% (95% CI = 5.7-12.8) in domestic horses and 6% (95% CI = 1.9-12.2) in domestic dogs, whereas 7.5% (95% CI = 3-17.9) in wild squirrels and 0.2% (95% CI = 0.1-0.7) in wild mice. Funnel diagrams, Egger's tests, and Begg's tests showed no significant publication bias in the included studies.

Conclusions: Spatial epidemiology showed that coinfection with Bb and Ap in animals worldwide was most prevalent in the southwestern region of North America, whereas species epidemiology showed that coinfection was most prevalent in domesticated horses, followed by wild squirrels and domesticated dogs, but was less common in wild mice. These data on the epidemiological status of Bb and Ap coinfection in animals may help guide the prevention and treatment of zoonosis.

Background: Zoonotic infections, particularly those caused by non-typhoidal Salmonella (NTS), pose a significant disease burden. However, there is a notable lack of comprehensive and integrated studies employing the One Health approach to address Salmonella prevalence. In this study, we aimed to analyse NTS spatiotemporal prevalence, serovar distribution, and antimicrobial resistance (AMR) across China.

Methods: We conducted a systematic review and meta-analysis to understand the dynamics of NTS in a One Health context in China. We searched the CNKI, Wanfang, and PubMed databases for Chinese and English peer-reviewed articles published before 1 January 2022 dealing with Salmonella in the context of China. We examined the dynamic prevalence along the food chain, the risk of dominant serovars and the carriers' regional contribution by principal component analysis, and the AMR burden before and after the ban on using antimicrobials as feed additives across five decades. We used the inverse variance index as an indicator of the inconsistency across studies, and we adopted the restricted maximum likelihood model due to high heterogeneity for analysis with a 95% confidence level for the pooled prevalence estimate.

Results: Based on 562 retrieved high-quality studies during 1967-2021, representing 5 052 496 samples overall and 80 536 positive samples for NTS isolates, the overall average prevalence was 7.35% (95% confidence interval (CI) = 0.069-0.087), which was regionally relatively higher in northern China (8.19%; 95% CI = 0.078-0.117) than in southern China (6.94%; 95% CI = 0.067-0.088). Poultry was the primary vehicle for serovars Enteritidis and Indiana (especially in the north), while swine and ruminants for Typhimurium and Derby were the first to highlight the regional livestock contribution to serovar prevalence. The overall AMR rate was 73.63% (95% CI = 0.68-0.99), decreasing after the ban on excessive use of feed-based antibiotics in livestock since 2020, with a relatively low resistance towards front-line and last-resort drugs.

Conclusions: Our study emphasises the importance of adopting a One Health framework to better understand the zoonotic nature of human NTS and highlights the dominant serovars on food contamination and human infection. The similarity in AMR patterns between poultry and human isolates further emphasises the integrated approach for evaluating disease burden and implementing targeted interventions.