International Health最新文献

Background: Antimicrobial resistance (AMR) determinants on the ocular surface may contribute to poor treatment responses.

Methods: An exploratory comparative analysis of ocular surface AMR determinants, as determined by RNA-sequencing (RNA-seq), on patients presenting with corneal infections at the Proctor Medical Clinic at the University of California San Francisco in San Francisco, CA, USA, and the Queen Elizabeth Central Hospital at the Department of Ophthalmology of Kamuzu College of Health Sciences in Blantyre, Malawi, was conducted. All patients underwent swabbing of three sites on the ocular surface: cornea, ipsilateral conjunctiva, and contralateral conjunctiva.

Results: Mutations conferring macrolide resistance were present on the ocular surface in 58% (95% CI 44 to 71%) of the participants in Malawi and 32% (95% CI 20 to 46%) of the participants in San Francisco. Aminoglycosides resistance genes were also common on the ocular surface with 58% (95% CI 44 to 71%) prevalence in Malawi and 21% (95% CI 12 to 35%) in San Francisco. AMR was associated with poorer visual outcomes in a subset of patients.

Conclusions: As determined by RNA-seq, ocular surface AMR gene mutations are common in patients with infectious keratitis. Surveillance may be important for infectious keratitis treatment selection as well as providing guidance for antibiotic stewardship.

Background: To investigate the changes in lifestyle and mental conditions during the COVID-19 lockdown pre- and post-COVID-19 epidemic by analysing 0.1 million in the general population.

Methods: A questionnaire was used to collect demographic, lifestyle and mental condition information. Descriptive and χ2 tests were utilized to analyse the differences among the three groups. Multiple linear regression models were used to assess the impact of mental status.

Results: This study involved a total of 141 250 participants, with 68 533 individuals in 2019 (pre-COVID-19), 53 956 in 2021 (lockdown period) and 18 761 in 2023 (post-COVID-19). During the period of lockdown and post-COVID-19, there was a significant decrease in the proportion of male smokers, decreasing from 39.2% before the epidemic to 36.6% during the lockdown period and to 34.8% after the epidemic. The proportion of people with good dietary habits increased slightly during the lockdown period (71.2% vs 68.4%) and remained at 71.8% after the epidemic. The 30- to 39-y age group had the greatest increase in engaging in physical activity. Multiple regression analysis showed that mental health status is associated with age, gender, dietary habits, physical activity and sleeping condition.

Conclusions: The general population is well adapted to the COVID-19 epidemic and can actively face the impact of the epidemic. Furthermore, the alarm triggered by the outbreak has cause people pay more attention to a healthy lifestyle.

Microbial foodborne outbreaks are a severe public health challenge in Africa, which bears the highest global burden due to systemic vulnerabilities. Common microbial pathogens contaminate various foods, particularly raw and processed meats, leading to significant morbidity, mortality and economic losses. In this review, data from 31 studies encompassing 42 microbial foodborne outbreaks in Africa were synthesized, analyzed and visualized. Overall, 877 067 of infections and intoxications occurred, with 2064 hospitalizations and 2061 deaths. Salmonella enterica accounted for the most of infections and intoxication (53.6%), while Staphylococcus aureus caused the highest rate of outbreaks (21.4%). Clostridium botulinum was associated with the highest fatality (46.154%), followed by Listeria monocytogenes (20.323%). The implicated food vehicles in the outbreaks included processed meats (38.1%), cereals, legumes and tuber (21.43%), vegetables (9.52%) and seafood (7.14%). The key contributing factors were poor hygiene, inadequate food storage and limited compliance with food safety practices. Addressing critical deficiencies in food safety infrastructure, public awareness and hygiene practices requires enhanced surveillance systems, stricter regulatory frameworks, investment in infrastructure and public education campaigns. Efforts should prioritize the control of prevalent pathogens to mitigate the health and socioeconomic impacts of foodborne illnesses across the continent.

Background: This study was conducted to determine the prevalence of Giardia duodenalis infection and identify potential risk factors in a healthy population of children living in internally displaced persons (IDP) camps, in Mogadishu, Somalia.

Methods: A community-based cross-sectional study was conducted among children living in Deyniile and Kahda IDP settlements, Mogadishu. A total of 334 children were randomly selected for stool sample collection and a questionnaire was administered. Giardia infection was diagnosed by antigen detection using a rapid detection kit.

Results: The results showed that 32 of the 334 children were positive, giving an overall prevalence of 9.6%. We also found that 196 (58.7%) of the children did not wear footwear, and that a majority of the members of the household (308; 92.2%) practiced open defecation. The regression analysis revealed that children aged <5 y (p=0.002), households in the Kahda IDP camp (p=0.019) and families with >5 members in their households (p=0.034) all have a significantly higher risk of becoming infected with Giardia.

Conclusion: The study found that giardiasis persists in the IDP camps. Many of the risk factors were associated with giardiasis, highlighting the significance of parents' education and sanitation conditions in the children's well-being.

Background: Intimate partner violence (IPV) during pregnancy is a global public health issue associated with adverse maternal and newborn health outcomes. The aim of this study was to assess the magnitude of IPV during pregnancy and associated factors in rural Ethiopia.

Methods: A cross-sectional survey was conducted among 432 pregnant women in the rural Hadiya Zone, Central Ethiopia, in July 2023, using structured interview questionnaires. Multivariable logistic regression was performed and the results were reported using adjusted ORs (AORs) with 95% CIs.

Results: The overall prevalence of IPV during recent pregnancy was 38.37% (95% CI 33.82 to 43.18%). Among the specific forms of IPV, psychological, physical and sexual violence were 28.84% (95% CI 24.62 to 33.43%), 22.09% (95% CI 18.29 to 26.31%) and 20.70% (95% CI 17.02 to 24.84%), respectively. Key factors significantly associated with IPV during pregnancy included early marriage (before the age of 20 y), being uneducated, lower autonomy among women, husbands' cigarette smoking and alcohol consumption, poor knowledge of IPV among husbands and husbands' involvement in antenatal care (ANC). IPV during pregnancy was notably high in the study setting.

Conclusions: Empowering women with low literacy, addressing male substance abuse, raising IPV awareness, promoting women's autonomy and encouraging male involvement in ANC visits are critical for reducing IPV.

Background: The increasing frequency and severity of wildfires, exacerbated by climate change, population growth and land use changes, have escalated public health risks. These events are associated with respiratory and cardiovascular diseases and adverse mental health outcomes. Vulnerable populations, including children, older people and those with pre-existing health conditions, face particularly high risks.

Methods: This study evaluates the existing literature on wildfire-related health impacts. Key variables include publication frequency, geographic distribution, collaborative networks and funding patterns.

Results: Findings reveal a concentration of research in high-income regions, particularly North America and Europe, with limited studies from wildfire-prone but under-represented areas such as Latin America, Oceania, Africa and the Caribbean. This geographical disparity restricts comprehensive understanding and effective public health responses to wildfire impacts. The analysis also underscores the need for interdisciplinary approaches.

Conclusions: Wildfires continue to pose significant global public health challenges. There is a critical need for more inclusive research efforts, enhanced international collaboration and a stronger focus on health-specific outcomes, especially in under-represented regions. Expanding research in these areas is essential to inform effective public health policies and interventions that address the health risks posed by wildfires worldwide.

Background: Blood pressure (BP) trends are influenced by genetic, sociodemographic and lifestyle factors, with notable population-specific variations. This study assessed the impact of these determinants on BP in urban Nigerians to identify high-risk subgroups and inform targeted interventions.

Methods: We conducted a cross-sectional study of 5076 adults ages 18-92 y (51.1% female) from Lagos, Nigeria. Data were collected using a modified World Health Organization STEPS protocol, including standardized BP measurements. Multiple linear regression models evaluated the effects of sociodemographic (age, sex, education, marital status and occupation) and lifestyle factors (tobacco/alcohol use, physical activity and fruit/vegetable consumption) on systolic BP (SBP) and diastolic BP (DBP) trends.

Results: Age and marital status (married/cohabiting) significantly predicted higher SBP and DBP. Male sex, previously married, low physical activity and current tobacco use independently predicted elevated SBP, while alcohol consumption and employment type (salaried and self-employment) predicted higher DBP. The impacts of these factors on SBP and DBP ranged from β=0.03 to 0.28. Low fruit/vegetable consumption was not a significant independent predictor.

Conclusions: Sociodemographic and lifestyle factors exhibit unique patterns in influencing BP among urban Nigerians. Tailored public health strategies, including alcohol/tobacco risk awareness, access to health screening and socio-economic/marital support, are essential for effective hypertension prevention in this population.

The coronavirus disease 2019 (COVID-19) pandemic posed significant threats to maintaining malaria services in Nigeria and threatened to reverse global progress towards elimination of the disease. During the COVID-19 pandemic, we worked in collaboration with the National Malaria Elimination Programme in Nigeria across 11 states to ensure that malaria campaigns and routine services continued. Here, we share the challenges and experiences from developing and implementing operational guidelines that enabled programmes to be adapted during unpredictable situations. The modifications made to long-lasting insecticide-treated net distribution and seasonal malaria chemoprevention campaign strategies enabled wide coverage of these interventions, despite limitations imposed by lockdowns. Strong partnerships were essential for the continued delivery of malaria services during lockdowns, which also highlighted the importance of community health workers during emergencies.

Family planning is crucial in improving maternal and child health, reducing fertility rates and promoting gender equity. Despite global advancements in contraceptive access, disparities persist across the League of Arab States due to sociocultural, economic and policy barriers. Understanding the effectiveness of existing family planning interventions in this region is essential for addressing unmet needs and guiding policy improvements. This scoping review aims to identify and appraise family planning interventions conducted across the League of Arab States. A comprehensive search of 14 databases was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines, focusing on studies published between 2010 and December 2024. The review included intervention-based studies that assessed family planning outcomes in Arabic-speaking countries. Data were extracted and tabulated. Seventeen intervention studies were identified, with the majority conducted in Jordan and Egypt. Effective interventions included pharmacist-led education, multisectoral collaborations, behavioural economics approaches and crisis-responsive strategies. While most studies reported positive effects on contraceptive uptake and knowledge, challenges such as low male engagement, provider resistance and sustainability concerns persisted. Interventions in crisis-affected settings demonstrated adaptability, but scalability remains a key issue. Future efforts should focus on culturally tailored strategies, long-term intervention sustainability and integrating family planning with broader health and economic empowerment programs.