Pub Date : 2025-12-23DOI: 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.
{"title":"Altitude of area of residence as a risk factor for stunting in children aged 0–60 months: A systematic review and meta-analysis","authors":"Dina Fitriana Rosyada , Toto Sudargo , Indah Kartika Murni","doi":"10.1016/j.dialog.2025.100268","DOIUrl":"10.1016/j.dialog.2025.100268","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Purpose</h3><div>This study aims to evaluate existing evidence regarding the effect of altitude on stunting cases in children 0–60 month.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"8 ","pages":"Article 100268"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926208","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}
Pub Date : 2025-12-23DOI: 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.
{"title":"Socio-ecological model: Understanding facilitators and barriers to HIV testing and counseling uptake in sub-Saharan Africa – A systematic review","authors":"Amanda Debuo Der , Elvis Enowbeyang Tarkang","doi":"10.1016/j.dialog.2025.100273","DOIUrl":"10.1016/j.dialog.2025.100273","url":null,"abstract":"<div><h3>Objective</h3><div>This systematic review examined the facilitators and barriers to HTC uptake among adults in SSA using the socio-ecological model (SEM).</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 %).</div></div><div><h3>Conclusion</h3><div>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.</div><div><strong>PROSPERO ID:</strong> CRD42024583105.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"8 ","pages":"Article 100273"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926206","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}
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。
{"title":"Changing the narrative: Socioeconomic determinants, not gun ownership, drive global homicide rates across 237 countries and territories","authors":"Rae-Anne Kastle , Shelby Baxter , Christine Edomwande , An-Lin Cheng , Michael Moncure , Cuthbert Simpkins","doi":"10.1016/j.dialog.2025.100270","DOIUrl":"10.1016/j.dialog.2025.100270","url":null,"abstract":"<div><div>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. <em>P</em>-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 (r<sup>2</sup> = 0·55; <em>p</em> < 0·0001) and maternal mortality ratio (r<sup>2</sup> = 0·52; <em>p</em> < 0·0001). Linear regression showed that the Gini Index (r<sup>2</sup> = 0·60; p < 0·0001) and poverty rate (r<sup>2</sup> = 0·44; <em>p</em> = 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.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"8 ","pages":"Article 100270"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926207","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}
Pub Date : 2025-12-23DOI: 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.
{"title":"An emerging theoretical lens post global epidemic and turmoil: Psychological immunity","authors":"Yi Xiao , Wei Wang , Xiping Hu","doi":"10.1016/j.dialog.2025.100271","DOIUrl":"10.1016/j.dialog.2025.100271","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"8 ","pages":"Article 100271"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926209","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}
Pub Date : 2025-12-21DOI: 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.
{"title":"Predicting nurse burnout: A logistic regression approach to workplace and demographic factors","authors":"Edona Haxhija , Drita Kruja , Zamira Shabani","doi":"10.1016/j.dialog.2025.100267","DOIUrl":"10.1016/j.dialog.2025.100267","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to identify key occupational and demographic factors associated with nurse burnout in a major public hospital in Albania.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"8 ","pages":"Article 100267"},"PeriodicalIF":0.0,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926205","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}
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.
{"title":"Strengthening mobile diagnostic resilience in emergencies in the WHO Eastern Mediterranean Region","authors":"Rana Abu Salbi , Jessica Yazbek , Deesse Tabet , Wasiq Mehmood Khan , Ghazi Kayali","doi":"10.1016/j.dialog.2025.100269","DOIUrl":"10.1016/j.dialog.2025.100269","url":null,"abstract":"<div><h3>Purpose</h3><div>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.</div></div><div><h3>Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"8 ","pages":"Article 100269"},"PeriodicalIF":0.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926202","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}
Pub Date : 2025-12-12DOI: 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.
{"title":"Determinants of COVID-19 prevalence in Central Java, Indonesia: An ecological study of socio-demographic, environmental, and healthcare factors","authors":"Iqbal Ardiansyah , Agus Subagiyo , Arif widyanto , Army Mitasari","doi":"10.1016/j.dialog.2025.100263","DOIUrl":"10.1016/j.dialog.2025.100263","url":null,"abstract":"<div><div>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 R<sup>2</sup> 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.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"8 ","pages":"Article 100263"},"PeriodicalIF":0.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791738","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}
Pub Date : 2025-12-11DOI: 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.
{"title":"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","authors":"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","doi":"10.1016/j.dialog.2025.100266","DOIUrl":"10.1016/j.dialog.2025.100266","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Materials and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 % (<em>n</em> = 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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"8 ","pages":"Article 100266"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791740","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}
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。
{"title":"Integrating education-based interventions and machine learning for stunting prevention: A case study in East Lombok, Indonesia","authors":"Mhd. Lailan Arqam , Asno Azzawagama Firdaus , Ahmad Muslih Atmojo , Ginanjar Zukhruf Saputri , Furizal , Palahuddin , Retno Sirnopati","doi":"10.1016/j.dialog.2025.100264","DOIUrl":"10.1016/j.dialog.2025.100264","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"8 ","pages":"Article 100264"},"PeriodicalIF":0.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738558","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}