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Altitude of area of residence as a risk factor for stunting in children aged 0–60 months: A systematic review and meta-analysis 居住地海拔是0-60月龄儿童发育迟缓的危险因素:一项系统回顾和荟萃分析
Pub Date : 2025-12-23 DOI: 10.1016/j.dialog.2025.100268
Dina Fitriana Rosyada , Toto Sudargo , Indah Kartika Murni

Background

Altitude has not been a factor considered in stunting incidence. Several studies have found that higher elevations increase a child's risk of stunting. However, many cases of stunting also occur in lowland areas. Accurate evidence is needed to justify the influence of altitude on stunting incidence globally, so that policies and interventions can be more specific.

Purpose

This study aims to evaluate existing evidence regarding the effect of altitude on stunting cases in children 0–60 month.

Methods

This design was a meta-analysis. We search for relevant articles from 2014 to 2024 from Pubmed, Science Direct, Sage Journal, Scopus, and Oxford academic. Two independent reviewers extracted data from the selected studies, including baseline information, strategies, screening processes, inclusion and exclusion criteria, data extraction, study quality evaluation, and statistical analysis. The Joanna Briggs Institute conducted the critical appraisal. All data analyses were performed using RevMan 5.3 with multiple logistic regression analysis.

Results

The electronic search yielded a total of 805 articles, and 5 articles met the inclusion criteria for meta-analysis. Children living in highland areas have a 2.91 times higher risk of stunting compared to those living in lowland areas (OR = 2.91; 95 % CI: 2.44–3.48). Highland areas face challenges in limited access to health care, low education, less diverse food, and poverty.

Conclusions

This study provides suggestions for increasing the number of health workers and health services, premarital education for childcare, and the provision of nutritional supplements for children.
身高并不是发育不良发生率的一个考虑因素。几项研究发现,较高的海拔会增加儿童发育迟缓的风险。然而,许多发育迟缓病例也发生在低地地区。需要准确的证据来证明海拔对全球发育迟缓发病率的影响,以便使政策和干预措施更加具体。目的本研究旨在评估海拔对0-60月龄儿童发育迟缓的影响。方法本设计采用荟萃分析。我们从Pubmed、Science Direct、Sage Journal、Scopus和Oxford academic检索2014 - 2024年的相关文章。两名独立审稿人从选定的研究中提取数据,包括基线信息、策略、筛选过程、纳入和排除标准、数据提取、研究质量评价和统计分析。乔安娜布里格斯研究所进行了批判性评估。所有数据均采用RevMan 5.3软件进行多元逻辑回归分析。结果共检索到805篇文献,其中5篇符合meta分析的纳入标准。生活在高地地区的儿童发育迟缓的风险比生活在低地地区的儿童高2.91倍(OR = 2.91; 95% CI: 2.44-3.48)。高地地区面临的挑战包括获得保健服务的机会有限、教育程度低、食物种类较少以及贫困。结论本研究为增加卫生人员和卫生服务、加强婚前托儿教育和提供儿童营养补充提供了建议。
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引用次数: 0
Socio-ecological model: Understanding facilitators and barriers to HIV testing and counseling uptake in sub-Saharan Africa – A systematic review 社会生态模型:了解撒哈拉以南非洲地区艾滋病毒检测和咨询的促进因素和障碍-系统综述
Pub Date : 2025-12-23 DOI: 10.1016/j.dialog.2025.100273
Amanda Debuo Der , Elvis Enowbeyang Tarkang

Objective

This systematic review examined the facilitators and barriers to HTC uptake among adults in SSA using the socio-ecological model (SEM).

Methods

A systematic search of Google Scholar, PubMed, Scopus, Sociological Abstracts, PsycINFO and Europe PMC identified 114 HTC uptake studies in SSA from 2010 to 2023 of which 6 met the inclusion criteria. The search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results

Individual level facilitators of HTC included high perceived HIV risk, privacy, higher education, and prior testing experience while low HIV knowledge, fear of positive results, stigma, and lack of confidence in self-testing were barriers. Interpersonal facilitators included partner and peer support, and peer normalization of testing, while barriers involved fear of partner reactions, trust concerns, and fear of unintentional disclosure. At the health system-level, facilitators included counseling, positive experiences with providers, and no discrimination while privacy concerns, stigma, and judgmental attitudes of healthcare workers hindered HTC uptake. The community-level barriers included misconceptions and stigma, whereas community-based education improved HTC uptake. At the policy level, cost was a barrier, but availability of self-testing facilitated uptake. The interpersonal factors presented the most significant facilitators (53.3 %), while the policy-level factors were the most significant barriers (57.1 %).

Conclusion

HTC uptake in SSA is shaped by intersecting SEM factors. Understanding these influences are essential for designing effective interventions to improve HTC uptake and linkage to care.
PROSPERO ID: CRD42024583105.
目的利用社会生态模型(SEM)对SSA地区成人摄取HTC的促进因素和障碍进行系统评价。方法系统检索谷歌Scholar、PubMed、Scopus、Sociological Abstracts、PsycINFO和Europe PMC,共检索到2010 - 2023年SSA中114篇HTC摄取研究,其中6篇符合纳入标准。搜索遵循系统评价和荟萃分析(PRISMA)指南的首选报告项目。结果个体层面的促进因素包括HIV风险认知高、隐私、高等教育程度和既往检测经验,而HIV知识低、对阳性结果的恐惧、耻辱感和对自我检测缺乏信心是阻碍因素。人际关系促进因素包括伴侣和同伴的支持,以及同伴对测试的规范化,而障碍包括对伴侣反应的恐惧,信任问题,以及对无意披露的恐惧。在卫生系统层面,促进因素包括咨询,与提供者的积极经验,没有歧视,而隐私问题,污名和卫生保健工作者的判断态度阻碍了HTC的采用。社区层面的障碍包括误解和耻辱感,而社区教育提高了HTC的接受程度。在政策一级,费用是一个障碍,但自检的可用性促进了接受。人际因素是最显著的促进因素(53.3%),政策层面因素是最显著的阻碍因素(57.1%)。结论SSA的htc摄取是由交叉的SEM因素决定的。了解这些影响对于设计有效的干预措施以改善HTC的吸收和与护理的联系至关重要。普洛斯彼罗id: crd42024583105。
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引用次数: 0
Changing the narrative: Socioeconomic determinants, not gun ownership, drive global homicide rates across 237 countries and territories 改变叙事:在237个国家和地区,推动全球凶杀率的是社会经济决定因素,而不是枪支所有权
Pub Date : 2025-12-23 DOI: 10.1016/j.dialog.2025.100270
Rae-Anne Kastle , Shelby Baxter , Christine Edomwande , An-Lin Cheng , Michael Moncure , Cuthbert Simpkins
Intentional homicide is defined as the unlawful taking of a human life with the intent to cause death or serious injury. Gun ownership is often at the forefront of debates regarding IH, but few have explored this relationship worldwide. Our study seeks to fill this gap by examining the relationship between civilian gun ownership and IH rates globally, while also analyzing various socioeconomic determinants. To investigate this relationship, we conducted a retrospective, cross-national review using publicly available data reported from government websites and public health journals across 237 countries and territories. Spearman Correlation analysis, multivariable linear regression, and ANOVA were conducted with homicide rates as the dependent variable and were repeated after countries were stratified by gross national income. P-values <0·05 were considered significant. Civilian gun ownership did not correlate with IH rates with and without the stratification. The dependent variables that showed the strongest positive correlations with IH rates included Gini Index (r2 = 0·55; p < 0·0001) and maternal mortality ratio (r2 = 0·52; p < 0·0001). Linear regression showed that the Gini Index (r2 = 0·60; p < 0·0001) and poverty rate (r2 = 0·44; p = 0·033) can be used to calculate possible IH rates. Gini Index had a positive correlation with IH in lower-income countries. Globally, we found that the Gini Index and poverty rates were strongly associated with IH rates, while there was no correlation between civilian gun ownership. This suggests there are several underlying socioeconomic factors, rather than gun ownership alone, that contribute to IH globally.
故意杀人罪被定义为非法夺取人的生命,意图造成死亡或严重伤害。枪支所有权经常是关于IH的争论的前沿,但很少有人在世界范围内探讨这种关系。我们的研究试图通过研究全球民用枪支所有权与IH率之间的关系来填补这一空白,同时也分析了各种社会经济决定因素。为了调查这种关系,我们利用237个国家和地区的政府网站和公共卫生期刊上报告的公开数据进行了一项回顾性的跨国审查。以杀人率为因变量进行Spearman相关分析、多变量线性回归和方差分析,并在按国民总收入分层后重复进行。p值<;0·05被认为是显著的。无论是否分层,平民枪支拥有率都与IH率无关。与妊高征率呈正相关的因变量包括基尼系数(r2 = 0.55; p < 0.0001)和孕产妇死亡率(r2 = 0.52; p < 0.0001)。线性回归表明,基尼指数(r2 = 0.60; p < 0.0001)和贫困率(r2 = 0.44; p = 0.033)可用于计算可能的IH率。在低收入国家,基尼指数与IH呈正相关。在全球范围内,我们发现基尼指数和贫困率与艾滋病毒感染率密切相关,而平民枪支拥有率之间没有相关性。这表明,在全球范围内,有几个潜在的社会经济因素,而不仅仅是枪支所有权,导致了IH。
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引用次数: 0
An emerging theoretical lens post global epidemic and turmoil: Psychological immunity 一个新兴的理论镜头后全球流行病和动荡:心理免疫
Pub Date : 2025-12-23 DOI: 10.1016/j.dialog.2025.100271
Yi Xiao , Wei Wang , Xiping Hu
The concept of psychological immunity is not a new idea. In response to the escalating conflicts and chaos that characterizes this era, we conducted this study and reviewed psychological immunity theory from the perspective of psychiatry, psychology, and philosophy. We found that growing evidence has demonstrated the connection between biological and psychological immunity process. This indicates an integrated immunity system that has developed over time for survival in both physical and metaphysical sense. The process-oriented conceptualization of psychological immunity is presented, as well as its intra- and inter-mechanism. We also discussed research, practice, and policy potentials of this field and advocated for its protective application at individual and societal level. Limitations and future research were addressed accordingly.
心理免疫的概念并不是一个新概念。为了应对这个时代不断升级的冲突和混乱,我们进行了这项研究,并从精神病学、心理学和哲学的角度对心理免疫理论进行了回顾。我们发现,越来越多的证据表明,生物免疫过程和心理免疫过程之间存在联系。这表明一个综合的免疫系统,随着时间的推移,在物理和形而上学的意义上发展了生存。提出了心理免疫的过程导向概念,以及心理免疫的内部机制和内部机制。我们还讨论了该领域的研究、实践和政策潜力,并提倡在个人和社会层面上对其进行保护性应用。并指出了局限性和未来的研究方向。
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引用次数: 0
Predicting nurse burnout: A logistic regression approach to workplace and demographic factors 预测护士职业倦怠:工作场所和人口因素的逻辑回归方法
Pub Date : 2025-12-21 DOI: 10.1016/j.dialog.2025.100267
Edona Haxhija , Drita Kruja , Zamira Shabani

Purpose

This study aimed to identify key occupational and demographic factors associated with nurse burnout in a major public hospital in Albania.

Methods

A descriptive cross-sectional survey was conducted among nurses in a regional hospital. Nursing management invited all units to participate. Nurses completed the questionnaire voluntarily and anonymously during breaks. The survey included job satisfaction, burnout risk, working conditions, supervisor and colleague support, workload, shift duration, career opportunities, and demographic variables. Cluster analysis was used to categorize nurses, and exploratory factor analysis examined the structure of job satisfaction factors.

Results

Data from 345 nurses showed that high workload and long shifts significantly increased burnout risk. Strong supervisor support and greater job satisfaction were associated with reduced burnout. Nurses in rural settings had 1.57 times higher odds of burnout compared to urban nurses. Female nurses had 1.25 times greater odds of burnout than male nurses. Advanced education and better career advancement opportunities were linked to lower burnout levels.

Conclusion

Burnout is more prevalent among rural nurses and, to a lesser extent, among female nurses, suggesting the need for context-sensitive and inclusive interventions. Burnout stems from systemic challenges such as excessive workload, insufficient managerial support, and role misalignment. Addressing these issues requires organizational changes including staffing improvements, supportive leadership, and professional development. Future research should apply standardized burnout measures and longitudinal approaches to better understand nurse well-being.
目的本研究旨在确定阿尔巴尼亚一家大型公立医院护士职业倦怠相关的关键职业和人口因素。方法对某地区医院护士进行描述性横断面调查。护理管理部门邀请各单位参与。护士在休息时间自愿匿名完成问卷。调查包括工作满意度、倦怠风险、工作条件、主管和同事支持、工作量、轮班时间、职业机会和人口统计变量。采用聚类分析对护士进行分类,探索性因素分析对护士工作满意度的影响因素进行结构分析。结果345名护士的数据显示,高工作量和长班次显著增加了倦怠风险。强有力的主管支持和更高的工作满意度与减少倦怠有关。农村护士的职业倦怠率是城市护士的1.57倍。女护士的职业倦怠率是男护士的1.25倍。高等教育和更好的职业发展机会与较低的倦怠水平有关。结论职业倦怠在农村护士中更为普遍,在女护士中比例较低,提示需要采取情境敏感和包容性的干预措施。职业倦怠源于系统挑战,如工作量过大、管理支持不足和角色错位。解决这些问题需要组织变革,包括人员配备改进、支持性领导和专业发展。未来的研究应采用标准化的倦怠测量和纵向方法来更好地了解护士的幸福感。
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引用次数: 0
Strengthening mobile diagnostic resilience in emergencies in the WHO Eastern Mediterranean Region 加强世卫组织东地中海区域紧急情况下的流动诊断复原力
Pub Date : 2025-12-17 DOI: 10.1016/j.dialog.2025.100269
Rana Abu Salbi , Jessica Yazbek , Deesse Tabet , Wasiq Mehmood Khan , Ghazi Kayali

Purpose

The Eastern Mediterranean Region faces persistent challenges in laboratory capacity, exacerbated by conflicts, natural disasters, and recurrent public health emergencies. The COVID-19 pandemic further exposed these deficiencies, underscoring the urgent need for scalable and rapid diagnostic solutions. Rapid Response Mobile Laboratories (RRMLs), self-contained mobile diagnostic units that can be rapidly deployed to affected areas, offer flexible and efficient tools to address diagnostic and logistical gaps in fragile healthcare systems.

Methods

We used document review and deliberative expert consultation, as this paper draws on the work of the Global Outbreak Alert and Response Network (GOARN) Strategic Group for Diagnostic Surge Capacity, and insights from the WHO-convened expert meeting in Cairo (October 2024). Regional needs and priorities were reviewed to outline RRML deployment in conflict-affected and resource-limited countries of the Eastern Mediterranean Region (EMR).

Results

Key priorities identified include developing standard operating procedures for biosafety, logistics, and data management; establishing a regional funding mechanism to ensure sustainability and fostering inter-country agreements for rapid deployment and resource sharing. The twinning strategy was emphasized as a pivotal approach for knowledge transfer and strengthening local capacity.

Conclusion

A regional mobile laboratory network tailored to local needs is essential to build diagnostic resilience. Standardized training, simulation drills, and integrated data-sharing frameworks will optimize the efficiency of RRMLs. Mobilizing resources and expertise for these laboratories will enhance outbreak preparedness and support public health responses in high-risk zones.
东地中海区域在实验室能力方面面临持续挑战,冲突、自然灾害和经常性突发公共卫生事件加剧了这一挑战。2019冠状病毒病大流行进一步暴露了这些缺陷,强调了对可扩展和快速诊断解决方案的迫切需要。快速反应移动实验室(RRMLs)是可以快速部署到受影响地区的独立移动诊断单元,为解决脆弱的卫生保健系统中的诊断和后勤差距提供了灵活和有效的工具。方法本文借鉴了全球疫情警报和反应网络(GOARN)诊断激增能力战略小组的工作,以及世卫组织在开罗召开的专家会议(2024年10月)的见解,我们采用了文件审查和审议性专家咨询的方法。审查了区域需要和优先事项,以概述在东地中海区域受冲突影响和资源有限的国家部署区域预防犯罪行动。确定的关键优先事项包括制定生物安全、物流和数据管理的标准操作程序;建立一个区域筹资机制,以确保可持续性,促进国家间快速部署和资源共享协议。强调孪生战略是知识转移和加强地方能力的关键方法。结论建立适应当地需求的区域性移动实验室网络是建立诊断复原力的必要条件。标准化训练、模拟演练和集成数据共享框架将优化RRMLs的效率。为这些实验室调动资源和专门知识,将加强疫情防范,并支持高危地区的公共卫生应对。
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引用次数: 0
Systems thinking in action: Lessons from Jharkhand's journey to reducing maternal mortality 行动中的系统思考:贾坎德邦降低孕产妇死亡率之旅的经验教训
Pub Date : 2025-12-13 DOI: 10.1016/j.dialog.2025.100265
Sanjeev Kumar , Anand Kumar , Amit Kumar Goyal , Ramkrishna Kumar , Pranav Bhushan , Sarwar Khan , Ajit Kumar Singh , Vikas R. Kehsri
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引用次数: 0
Determinants of COVID-19 prevalence in Central Java, Indonesia: An ecological study of socio-demographic, environmental, and healthcare factors 印度尼西亚中爪哇COVID-19流行的决定因素:社会人口、环境和卫生保健因素的生态学研究
Pub Date : 2025-12-12 DOI: 10.1016/j.dialog.2025.100263
Iqbal Ardiansyah , Agus Subagiyo , Arif widyanto , Army Mitasari
Central Java, Indonesia, experienced a 40.9 % COVID-19 positivity rate in 2022, exceeding the WHO benchmark. This study examines the association between changes in sociodemographic, environmental, and healthcare factors and the rise in COVID-19 prevalence, focusing on regional disparities across Central Java. Variables from public datasets were chosen based on the Social Determinants of Health (SDOH) framework. Data analysis begins with variable identification via Pearson correlation, followed by an Ordinary Least Squares (OLS) regression employing Stepwise Backward Elimination, and subsequent assumption tests including Jarque-Bera, Breusch-Pagan, Moran's I, and multicollinearity checks. Upon identifying spatial autocorrelation and heteroscedasticity, Geographically Weighted Regression (GWR) was applied to address spatial heterogeneity. Ordinary Least Squares (OLS) analysis identified Change in tourist arrival ratio per population, environmental health workforce ratio per land area, and community healthcare workforce ratio per land area as associated factors with change in COVID-19 prevalence. The Geographically Weighted Regression (GWR) model, with a higher R2 value of 0.66, better accounted for regional variations, especially in central and eastern regions. The findings indicate that traveler mobility and the spatial distribution of community health workers are linked to increased COVID-19 prevalence, whereas environmental health workers are associated with a protective result, but these are associations at the aggregate (district/city) level and may be influenced by confounding or reverse causation. Structural factors such as unequal access to resources, healthcare, and sanitation, driven by tourism-induced social inequality, contribute to the disproportionate impact of COVID-19 on vulnerable communities, making it essential for policymakers to address these disparities to protect both local populations and visitors. The study recommends regulating risk-based tourist activities, expanding the environmental health workforce, and enhancing spatial monitoring systems to inform evidence-based health policy.
印度尼西亚中爪哇在2022年的COVID-19阳性率为40.9%,超过了世卫组织的基准。本研究考察了社会人口、环境和医疗保健因素的变化与COVID-19患病率上升之间的关系,重点关注中爪哇的区域差异。根据健康的社会决定因素(SDOH)框架从公共数据集中选择变量。数据分析首先通过Pearson相关性进行变量识别,然后采用逐步反向消去法进行普通最小二乘(OLS)回归,然后进行假设检验,包括Jarque-Bera、Breusch-Pagan、Moran's I和多重共线性检验。在识别空间自相关和异方差的基础上,应用地理加权回归(GWR)分析空间异质性。普通最小二乘(OLS)分析发现,人均游客到达率、人均土地面积环境卫生人力比率和人均土地面积社区卫生人力比率的变化与COVID-19流行率变化相关。地理加权回归(GWR)模型的R2值较高,为0.66,较好地反映了区域差异,特别是中东部地区。研究结果表明,旅行者流动性和社区卫生工作者的空间分布与COVID-19患病率增加有关,而环境卫生工作者与保护性结果有关,但这些都是在总体(区/市)层面上的关联,可能受到混杂或反向因果关系的影响。由旅游业引发的社会不平等造成的资源、医疗保健和卫生设施获取不平等等结构性因素,助长了COVID-19对弱势社区的不成比例影响,因此政策制定者必须解决这些差异,以保护当地居民和游客。该研究建议规范基于风险的旅游活动,扩大环境卫生人力,并加强空间监测系统,为基于证据的卫生政策提供信息。
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引用次数: 0
Functions and challenges of a government-run animal bite treatment center in the delivery of rabies post-exposure prophylaxis services in Iloilo City, Philippines: A 6-year descriptive study, 2018–2023 菲律宾伊洛伊洛市政府运营的动物咬伤治疗中心在提供狂犬病暴露后预防服务方面的功能和挑战:一项为期6年的描述性研究,2018-2023
Pub Date : 2025-12-11 DOI: 10.1016/j.dialog.2025.100266
Anna-Lee B. Bandoy , Neil Marc S. Dasas , Alpha Issa Christianne P. Abegonia , John Piox J. Badiang , Chester Lloyd S. Berdan , Maria Lucille M. Magallanes , Jes Ivan D. Sian , Therese A. Sumague , Patricia Kei P. Tulio , Addy Mae P. Binoya , Ma. Cristina L. Erum , Alfredo A. Hinay Jr

Background

Animal bite injuries are a serious public health concern due to the risk of rabies infection. In March 2024, the Department of Health (DOH) reported 84 rabies cases with six fatalities from Iloilo City. The most crucial management of animal bite injuries includes immediate wound care and rabies post-exposure prophylaxis (PEP), typically administered at an Animal Bite Treatment Center (ABTC). In 2007, the Philippines established the Republic Act No. 9482, also known as the Anti-Rabies Act, which created the National Rabies Prevention and Control Program (NRPCP) to control and eliminate rabies. This study aimed to describe the functions and challenges faced by one of these government-run ABTCs in Iloilo City, specifically a) provision of rabies PEP for animal bite cases, b) instructions for proper wound care, c) documentation of animal bite cases, and d) conduct of health promotion activities.

Materials and methods

This mixed-methods study was conducted at an ABTC in Iloilo City between January and March 2024. The first phase of the study collected secondary data from the official registry from January 1, 2018, to December 31, 2023. In the second phase, data were collected through direct observation of practices during a site visit in February 2024. A validated checklist based on the DOH Manual of Operations and WHO health system framework was developed and used for objective points of observation. Descriptive analyses of frequencies and percentages were conducted using Microsoft Excel and compared with the NRPCP guidelines. Also, Mann-Kendall test was conducted to evaluate the temporal trends in bite incidence proportions.

Results

The non-hospital-based government ABTC operated under the Iloilo City Health Office provided a.) rabies PEP and wound care for animal bite cases, b.) documentation of animal bite cases, and c.) awareness campaigns. A total of 20,134 animal bite cases were documented from 2018 to 2023. Three types of vaccines were delivered to the center: Purified Vero Cell Rabies (PVRV) and Purified Chicken Embryo Cell (PCEC) for active immunization, and Equine Rabies Immunoglobulin (ERIG) for passive immunization. In 2023, the lowest number of category III ERIG recipients was 42.65 % (n = 534). Despite COVID-19 restrictions from 2020 to the middle of 2022, all patients completed their TCV vaccination between 2020 and 2023. Challenges, such as vaccine shortages, record inconsistencies, and referral issues, persist.

Conclusion

The non-hospital-based government-run ABTC has maintained rabies PEP services in Iloilo City from 2018 to 2023, despite challenges. Collaboration with the Local Government Unit (LGU) and DOH, increased campaigns, and lay lectures on the prevention of animal bites and rabies infection, along with increased healthcare funding, are needed for sustainable solutions.
动物咬伤是一个严重的公共卫生问题,因为有感染狂犬病的风险。2024年3月,卫生部报告了伊洛伊洛市84例狂犬病病例,其中6例死亡。动物咬伤最关键的处理包括立即伤口护理和狂犬病暴露后预防(PEP),通常在动物咬伤治疗中心(ABTC)实施。2007年,菲律宾制定了第9482号共和国法案,也被称为“反狂犬病法案”,该法案创建了国家狂犬病预防和控制计划(NRPCP),以控制和消除狂犬病。本研究旨在描述伊洛伊洛市其中一个政府经营的动物咬伤中心的功能和面临的挑战,特别是a)为动物咬伤病例提供狂犬病PEP, b)正确伤口护理指导,c)动物咬伤病例记录,以及d)开展健康促进活动。材料和方法这项混合方法研究于2024年1月至3月在伊洛伊洛市的一家ABTC进行。该研究的第一阶段从2018年1月1日至2023年12月31日从官方登记处收集了二手数据。在第二阶段,在2024年2月的实地考察期间,通过直接观察实践收集数据。根据卫生部业务手册和世卫组织卫生系统框架制定了一份经过验证的核对表,并用于客观观察点。使用Microsoft Excel对频率和百分比进行描述性分析,并与NRPCP指南进行比较。采用Mann-Kendall检验评估咬伤发生率的时间趋势。结果伊洛伊洛市卫生局属下的非医院型政府狂犬病预防中心提供了a)动物咬伤病例的狂犬病预防措施和伤口护理,b)动物咬伤病例记录,c)宣传活动。从2018年到2023年,共记录了20134例动物咬伤病例。三种疫苗被送到该中心:用于主动免疫的纯化Vero细胞狂犬病(PVRV)和纯化鸡胚细胞狂犬病(PCEC)疫苗和用于被动免疫的马狂犬病免疫球蛋白(ERIG)疫苗。2023年,III类ERIG接受者人数最少,为42.65% (n = 534)。尽管从2020年到2022年年中对COVID-19有限制,但所有患者都在2020年至2023年期间完成了TCV疫苗接种。疫苗短缺、记录不一致和转诊问题等挑战依然存在。结论2018 - 2023年,伊洛伊洛市政府办非医院ABTC虽面临挑战,但仍保持了狂犬病PEP服务。可持续的解决方案需要与地方政府单位和卫生部合作,加强关于预防动物咬伤和狂犬病感染的宣传和讲座,同时增加卫生保健资金。
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引用次数: 0
Integrating education-based interventions and machine learning for stunting prevention: A case study in East Lombok, Indonesia 将基于教育的干预措施和机器学习结合起来预防发育迟缓:印度尼西亚东龙目岛的案例研究
Pub Date : 2025-12-06 DOI: 10.1016/j.dialog.2025.100264
Mhd. Lailan Arqam , Asno Azzawagama Firdaus , Ahmad Muslih Atmojo , Ginanjar Zukhruf Saputri , Furizal , Palahuddin , Retno Sirnopati
One of the regions in Indonesia that has the highest prevalence of stunting cases is West Nusa Tenggara, with a percentage of cases almost reaching 12.7 %, even though this province is a priority target for stunting reduction by 2022. Specifically in the East Lombok region, this study took this location point because of the high number of stunting cases in West Nusa Tenggara. Puskesmas Denggen was the target of the study, covering six working areas namely Denggen, East Dengen, Majidi, Rakam, Sekarteja, and Pancor, with a total of 3416 under-five data. The data were obtained through two measurements: the initial in February 2024 and the final in August 2024. This research integrates a multidisciplinary approach, encompassing health and nutrition science, psychology, education, and religion, to create comprehensive interventions for stunting prevention and employs machine learning models to predict future cases. The interventions include Motivation, Hygiene, Nutrition, Mental Health, and Infant Health, which are designed to cover all the essential needs of children in the growth and development process. The results of the six villages measured showed that significant changes in data were obtained in Denggen Village when compared before and after the intervention. The results of measuring the effectiveness of the anti-stunting educational interventions were also found to be effective across the five key aspects, with several showing dominant and statistically significant improvements. The machine learning algorithms used also achieved very high accuracy using Decision Tree and Gaussian Naive Bayes. This anti-stunting education model can be applied to the same case in a wider scope by paying attention to several aspects as an evaluation.
印度尼西亚发育迟缓病例发病率最高的地区之一是西努沙登加拉,尽管该省是到2022年减少发育迟缓的优先目标,但该地区的病例比例几乎达到12.7%。特别是在东龙目岛地区,本研究之所以选择这个地点,是因为西努沙登加拉有大量发育迟缓病例。Puskesmas Denggen是该研究的目标,涵盖六个工作区域,即Denggen, East Dengen, Majidi, Rakam, Sekarteja和Pancor,共有3416个5岁以下数据。数据是通过两次测量获得的:第一次是在2024年2月,最后一次是在2024年8月。这项研究整合了多学科方法,包括健康和营养科学、心理学、教育和宗教,为发育迟缓预防创造了全面的干预措施,并使用机器学习模型来预测未来的病例。干预措施包括动机、卫生、营养、心理健康和婴儿健康,旨在满足儿童在成长和发展过程中的所有基本需求。6个村的测量结果显示,干预前后,登根村的数据发生了显著变化。测量反发育迟缓教育干预措施有效性的结果也被发现在五个关键方面是有效的,其中几个方面显示出主导和统计显着的改善。使用的机器学习算法使用决策树和高斯朴素贝叶斯也达到了非常高的精度。这种反发育不良教育模式通过关注几个方面作为评价,可以在更广泛的范围内适用于同一案例。
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Dialogues in health
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