International Health最新文献

Background: Crimean-Congo Haemorrhagic Fever (CCHF) is a severe tick-borne viral disease. Increasing cases in West Africa suggest potential undetected circulation in Nigeria.

Methods: A One Health Joint Risk Assessment was conducted to identify transmission pathways and assess the likelihood and impact of human CCHF infections at the human-animal-environment interface in Nigeria. Risk framing involved developing structured questions for potential Crimean-Congo Haemorrhagic Fever virus (CCHFV) transmission scenarios. A scoping review was conducted and median seroprevalence values were reported. The likelihood, impact and data uncertainty for human infection scenarios were used for a qualitative estimation of risk.

Results: Human contact with infected livestock during farming, veterinary practices and exposure to ticks was identified as a key infection route. Most cases in Nigeria (66.7%) were identified via serology, with a median human seroprevalence of 6.1% and cattle seroprevalence of 30.2%. CCHFV has been isolated from Rhipicephalus ticks. Four risk assessment questions were defined and focused on veterinarians, abattoir workers, herders, wildlife rangers and healthcare workers. Animal-related professions had a moderate likelihood of infection.

Conclusion: Strengthening One Health surveillance, vector control and multisector infection prevention is crucial to reducing the risk of CCHF and averting future outbreaks.

A climate necropolitics of health offers a critical framework that illuminates how climate change disproportionately harms marginalized populations by highlighting how the lives of certain individuals are protected and whose lives are expendable. We demonstrate how entrenched gender inequity, colonial legacies and systemic underinvestment in health and education have had negative health impacts for women and girls in the Swat Valley in Pakistan. We propose that a climate necropolitics of health asks us to move beyond seeing climate disasters as an isolated event, instead locating them in broader histories of environmental injustice, structural violence and social exclusion.

Background: Rajasthan, a state in northwest India, experiences extreme heat, causing a plethora of health impacts. Understanding local practices for coping with heat is crucial for integrating with available scientific evidence and thereby in developing effective public health interventions. This study aimed to explore the sociocultural practices for adapting to heat stress and health-seeking behaviour for heat-related illnesses among the general population.

Methods: This was an exploratory descriptive qualitative study. In-depth (n=11) and key informant (n=5) interviews and focus group discussions (n=3) were conducted among various stakeholders, with a pretested interview guide. Typical case and intensity sampling techniques were used to recruit participants. Thematic analysis of the content was done manually by an inductive approach to identify various strategies in the community for adapting to heat stress.

Results: A total of 36 participants were involved in this study. They described a range of signs and symptoms experienced during extreme heat. There were mentions of several home remedies, including the use of tamarind paste, bentonite clay, decoction of spices and screw pine flowers. Sociocultural practices for heat adaptation included housing modifications, such as thatched roofs, use of mud and hay, coating with limestone and alum, installation of solar panels and the use of coolers for temperature control. Vocational adjustments, such as scheduling work during cooler times of the day and using wet clothes for heat relief, were also prevalent, with concerns about sickness absenteeism and loss of wages. People expressed their care for animals during the hot summers and nature conservation. Socio-economic disparities within the village are a major reason for challenges related to affordability. Criticisms were also placed on accessibility to a well-prepared health system.

Conclusions: The findings highlight the diverse range of sociocultural practices and health-seeking behaviours by people in rural areas of Rajasthan to cope with extreme heat. Incorporating indigenous knowledge and traditional practices into public health initiatives, after adequate validation, is essential for enhancing heat resilience and mitigating heat-related health risks in the region. Future research and interventions should consider context-specific approaches to heat adaptation, acknowledging the importance of local traditions and practices in promoting community health and well-being.

Background: Mycobacterium tuberculosis is a transmissible pathogen most commonly acquired through contact with an infectious individual. Early initiation of tuberculosis (TB) preventive treatment (TPT) in high-risk populations can substantially reduce the risk of TB infection (TBI) and/or progression to active disease. Our objectives were to identify risk factors for children and adolescents developing TBI and TB after exposure and to evaluate the diagnostic utility of chest computed tomography (CT).

Methods: A 6.5-year retrospective cohort study was conducted at a single centre in the Czech Republic to assess risk factors for TBI and TB in children and adolescents (0-18 y).

Results: Of 335 children included in the study (median age 6.85 y), TBI was diagnosed in 83 (25%) and TB in 39 (12%). Chest CT in 45 high-risk contacts identified TB in an additional 13 participants. The key TB risk factor was index patients having smear-positive TB (odds ratio [OR] 11.35), while older age of contacts (OR 0.83) and non-household exposure (OR 0.23) had a lower risk of TB. TBI risk increased with age (OR 1.21), index smear-positive patients (OR 4.66) and when the father was the index patient (OR 2.91). Ukrainian refugee children had higher risks of TB (relative risk 3.4). Adherence to TPT in those who qualified was good.

Conclusions: Risk factors for TBI and TB were identified, including children being from Ukraine. Chest CT may aid in early diagnosis of TB.

Background: Time-limited, externally funded self-help groups (receiving training, equipment and access to seeds) are typically evaluated during the funding period. However, their sustainability beyond this phase remains understudied.

Methods: This retrospective qualitative study explored the post-funding sustainability of two 6-y self-help interventions (2013-2019) for groups in integrated leprosy communities in central Nigeria. Semi-structured interviews were conducted with 40 stakeholders (beneficiaries, implementers and funders) and supplemented by document analysis.

Results: Findings revealed that most activities ceased after funding ended, with limited evidence of sustained benefits. In one community, sewing initiatives persisted, while the other showed no lasting impact. Challenges included inadequate maintenance of provided equipment (e.g. sewing machines, tricycles) and systemic barriers such as insecure land tenure and limited educational access.

Conclusions: The study highlights the fragility of externally funded self-help models in marginalised communities. Sustainability requires integration with broader economic systems and infrastructure support. Funders should prioritise long-term planning alongside short-term interventions.

Climate and environmental change are increasingly affecting skin health across Africa, but this remains under-recognised in global health discussions. Rising temperatures, ultraviolet radiation, pollution, flooding, deforestation, and droughts are reshaping the epidemiology of many cutaneous infections, inflammatory conditions, and malignancies. Unregulated cosmetic and antiseptic skincare products further compound both cutaneous and environmental harm. Addressing these emerging challenges is essential for health equity and resilience across the continent's rapidly evolving landscape. The recent World Health Assembly resolution on skin diseases as a global public health priority affirms this need to include dermatology and skin health in climate and environmental health policies.