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Prevalence and intersecting burdens of reproductive health morbidities among female fish farmers in the coastal region of Bangladesh 孟加拉国沿海地区女性养鱼户生殖健康发病率和交叉负担
Pub Date : 2025-09-01 DOI: 10.1016/j.glohj.2025.09.002
Md. Salah Uddin , Hossain Biswas , Mishkatul Jannat Megha , Eshita Ghosh , Shaharior Hashem , Mohammad Mahfujul Haque , Neaz A. Hasan

Background

Female fish farmers in coastal Bangladesh face significant reproductive health (RH) challenges due to occupational, nutritional, and sociocultural factors. However, their health burdens have been largely overlooked in labor and health policies.

Objectives

This study aims to investigate the prevalence, severity, determinants, and emotional and relationship consequences of RH morbidities among female fish farmers in Shyamnagar, Satkhira, Bangladesh.

Methods

A cross-sectional survey with structured questionnaires was conducted among 297 female fish farmers. Data were supplemented by rural appraisal activities. Descriptive statistics, chi-square tests, Poisson regression, and Structural Equation Modeling were used for analysis.

Results

The study found that 59.60 % (177/297) of participants suffered from moderate to severe uterine issues, remarkably menstrual irregularities (92.65 %, 164/177), backache (59.32 %, 105/177), pelvic and fatigue pain (42.37 %, 75/177), anemia (28.24 %, 50/177), with the “21‒30” year age group bearing a higher physiological burden with greater relational and emotional disruptions than “31‒40” year age group, and “41‒50” year age group women. High exposure to occupational chemicals (81.82 %, 243/297) and lack of personal protective equipment (93.94 %, 279/297) were key contributors. Access to formal healthcare is limited due to financial hardships (85.86 %, 255/297), social stigma (51.52 %, 153/297), and inadequate health services (46.47 %, 138/297). Structural Equation Modeling results also revealed significant associations among RH morbidities, emotional distress, social isolation, and diminishing well-being.

Conclusion

The study highlights the urgent need for integrated health policies addressing reproductive care, occupational safety, and mental health support for female fish farmers in coastal Bangladesh. Addressing these issues will improve their health, well-being, and resilience.
由于职业、营养和社会文化因素,孟加拉国沿海的女性养鱼户面临着重大的生殖健康(RH)挑战。然而,劳动和卫生政策在很大程度上忽视了她们的健康负担。目的本研究旨在调查孟加拉国萨奇拉县Shyamnagar的女性养鱼户RH发病率的流行程度、严重程度、决定因素以及情绪和关系后果。方法对297名女性养鱼户进行横断面调查,采用结构化问卷。农村评价活动补充了数据。采用描述性统计、卡方检验、泊松回归和结构方程模型进行分析。结果研究发现,59.60%(177/297)的参与者有中重度子宫问题、月经不规律(92.65%,164/177)、背痛(59.32%,105/177)、盆腔疼痛和疲劳性疼痛(42.37%,75/177)、贫血(28.24%,50/177),其中21-30岁年龄组的生理负担高于31-40岁年龄组和41-50岁年龄组。职业性化学品高暴露(81.82%,243/297)和缺乏个人防护装备(93.94%,279/297)是主要原因。由于经济困难(85.86%,255/297)、社会耻辱(51.52%,153/297)和卫生服务不足(46.47%,138/297),获得正规卫生保健的机会有限。结构方程建模结果还揭示了RH发病率、情绪困扰、社会孤立和幸福感下降之间的显著关联。结论本研究强调了孟加拉国沿海地区女性养鱼户迫切需要制定针对生殖保健、职业安全和心理健康支持的综合卫生政策。解决这些问题将改善他们的健康、幸福和适应力。
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引用次数: 0
Mapping government financing for antimicrobial resistance responses in East and Southern Africa: implications for sustainability and domestic ownership: a narrative review 绘制政府资助东部和南部非洲抗菌素耐药性反应的情况:对可持续性和国内所有权的影响:叙述性审查
Pub Date : 2025-09-01 DOI: 10.1016/j.glohj.2025.09.003
Ferris T. Munyonho , Oscar Mano , Silizani Masiku , Bridget Lumbwe , Hazel Musuka , Amon Nsengimana , Enos Moyo , Tafadzwa Dzinamarira

Background

Antimicrobial resistance (AMR) poses a significant and growing public health challenge in East and Southern Africa. Despite formal commitments to the National Action Plans, domestic financing for AMR remains critically limited, with most countries continuing to depend heavily on external donor funding.

Objective

This narrative review examines the current extent to which domestic fiscal commitments align with national AMR policy goals across the two regions.

Methods

Government websites for ministries of health and finance, donor platforms, and three academic databases (Scopus, JSTOR, Google Scholar) were searched for eligible articles. National budget statements and media reports were also reviewed where available. Three researchers independently screened titles and summaries, followed by full-text reviews to confirm eligibility.

Results

The findings reveal that while several countries have developed National Action Plans, very few have allocated domestic funding to implement them. Only Malawi, Nigeria and Uganda reported modest domestic contributions, while in other countries such as Zambia, Ethiopia, and South Africa, AMR programs remain largely donor-financed or lack dedicated budget lines altogether. Veterinary and laboratory sectors are particularly underfunded, with minimal integration into broader AMR strategies. While this review has several limitations including restricted access to current, comprehensive national budget data and a reliance on secondary sources such as donor and World Health Organization reports, which may introduce bias, the patterns identified in this review still offer valuable insight into regional funding dynamics and can inform future policy and research efforts.

Conclusion

We conclude that without dedicated domestic financing and accountability mechanisms, AMR efforts in the region may face significant sustainability challenges observed in other health responses such as human immunodeficiency virus. Strengthening AMR governance requires clear budgetary commitments, sustainable co-financing models, and policy instruments to reduce dependency on external support.
抗生素耐药性(AMR)对东非和南部非洲的公共卫生构成了重大且日益严重的挑战。尽管对国家行动计划作出了正式承诺,但抗菌素耐药性的国内资金仍然非常有限,大多数国家继续严重依赖外部捐助资金。本叙述性综述考察了这两个地区的国内财政承诺与国家抗微生物药物耐药性政策目标相一致的程度。方法检索卫生部、财政部政府网站、捐赠平台和三个学术数据库(Scopus、JSTOR、b谷歌Scholar),检索符合条件的文章。在可能的情况下也审查了国家预算报表和媒体报道。三位研究人员独立筛选标题和摘要,然后进行全文评审以确认其合格性。结果调查结果显示,虽然一些国家制定了国家行动计划,但很少有国家为实施这些计划拨出国内资金。只有马拉维、尼日利亚和乌干达报告了少量的国内捐款,而在赞比亚、埃塞俄比亚和南非等其他国家,抗菌素耐药性项目仍然主要由捐助者资助,或者根本没有专门的预算项目。兽医和实验室部门尤其资金不足,极少纳入更广泛的抗微生物药物耐药性战略。虽然这次审查有一些局限性,包括限制获取当前全面的国家预算数据,以及依赖捐助者和世界卫生组织报告等二手来源,这可能会产生偏见,但这次审查中确定的模式仍然为了解区域供资动态提供了宝贵的见解,并可以为未来的政策和研究工作提供信息。我们的结论是,如果没有专门的国内融资和问责机制,该地区的抗微生物药物耐药性工作可能面临重大的可持续性挑战,这与人类免疫缺陷病毒等其他卫生应对措施一样。加强抗微生物药物耐药性治理需要明确的预算承诺、可持续的联合融资模式和减少对外部支持依赖的政策工具。
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引用次数: 0
Core drug use indicators in Nigerian health facilities: a systematic review (1994–2024) 尼日利亚卫生机构的核心药物使用指标:系统审查(1994-2024年)
Pub Date : 2025-09-01 DOI: 10.1016/j.glohj.2025.10.001
Mustapha Muhammed Abubakar , Abdurrahman Murtala Bello , Henry Chiagoziem Iremeka , Abdulmuminu Isah , Chukwuemeka Nwachuya , Suleman Hayatu Sule , Ifeanyi Kanayo Ifeorah , Blessing Onyinye Ukoha-Kalu

Objectives

We systematically reviewed the rational use of medicines using the World Health Organization/International Network of Rational Use of Drugs (WHO/INRUD) core drug use indicators. We also assessed the impact of the coronavirus disease 2019 pandemic and the National Drug Policy (NDP) 2005 on the rational use of medicines.

Methods

Searches were conducted in PubMed, Scopus, and Google Scholar databases to identify studies that met our eligibility criteria. Assessment of the quality of studies was conducted using the Joanna Briggs Institute criteria for analytical studies. We reported and compared the median values of WHO/INRUD core drug use indicators with standard thresholds. Data were presented with median, interquartile range (IQR), and percentages. Mann-Whitney and Kruskal-Wallis tests were conducted to assess for statistical significance (P < 0.05) across variables.

Results

Thirty-one studies were included in the review, comprising 50,931 patient encounters across 268 health facilities. Within prescribing indicators, average number of medicines per patient encountered [3.4 (IQR: 3.0 to 4.0)], percentage of medicines prescribed by generic [50.4 % (IQR: 47.4 % to 65.0 %)], percentage of encounters with antibiotic prescribed [40.2 % (IQR: 30.5 % to 52.7 %)], percentage of encounters with injection prescribed [18 % (IQR: 3.2 % to 30.0 %)] and the percentage of medicines prescribed from essential medicines list [82.0 % (IQR: 66.4 % to 89.3 %)]. The median percentage of encounters with antibiotics (P = 0.04) and the median percentage of medicines prescribed by generics (P = 0.03) increased during and after the COVID-19 pandemic. Prescribing indicators were worse in primary and secondary health facilities, with significant differences in the median percentage of encounters with antibiotics (P = 0.007) and injections (P = 0.0002) across primary, secondary, and tertiary health facilities. There were improvements across all prescribing indicators after the implementation of NDP 2005.

Conclusions

Core drug use indicators in Nigerian health facilities deviated from the WHO/INRUD thresholds, with noticeable improvement after the implementation of NDP 2005. More efforts are needed to improve rational drug use in Nigerian hospitals.
目的采用世界卫生组织/国际合理用药网络(WHO/INRUD)核心用药指标,对合理用药情况进行系统回顾。我们还评估了2019冠状病毒病大流行和2005年国家药品政策对药物合理使用的影响。方法在PubMed、Scopus和b谷歌Scholar数据库中进行检索,以确定符合我们的资格标准的研究。研究质量的评估是使用乔安娜布里格斯研究所的分析研究标准进行的。我们报告并比较了WHO/INRUD核心药物使用指标的中位数与标准阈值。数据以中位数、四分位间距(IQR)和百分比呈现。采用Mann-Whitney检验和Kruskal-Wallis检验评估变量间的统计学显著性(P < 0.05)。结果本综述纳入了31项研究,包括268个医疗机构的50,931例患者就诊。在处方指标中,每位患者平均使用的药物数量[3.4 (IQR: 3.0 ~ 4.0)]、仿制药使用百分比[50.4% (IQR: 47.4% ~ 65.0%)]、使用抗生素使用百分比[40.2% (IQR: 30.5% ~ 52.7%)]、使用注射使用百分比[18% (IQR: 3.2% ~ 30.0%)]和使用基本药物清单中的药物使用百分比[82.0% (IQR: 66.4% ~ 89.3%)]。在COVID-19大流行期间和之后,抗生素接触的中位数百分比(P = 0.04)和仿制药处方的中位数百分比(P = 0.03)均有所增加。初级和二级卫生机构的处方指标较差,初级、二级和三级卫生机构的抗生素接触中位数百分比(P = 0.007)和注射中位数百分比(P = 0.0002)存在显著差异。《2005年国家发展规划》实施后,所有处方指标都有所改善。结论尼日利亚卫生机构的score药物使用指标偏离了世卫组织/INRUD的阈值,在实施NDP 2005后有明显改善。需要作出更多努力,改善尼日利亚医院的合理用药情况。
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引用次数: 0
AI agents and automation: the future of clinical pharmacy 人工智能代理和自动化:临床药学的未来
Pub Date : 2025-09-01 DOI: 10.1016/j.glohj.2025.09.001
Jane Thomason
Clinical pharmacy is on the cusp of exponential change powered by artificial intelligence agents, automation, data analytics, and robotics. Blockchain will enhance data integrity and transparency, and Augmented and Virtual Reality technologies will revolutionise training, patient education, and simulation-based care planning. Clinical pharmacists need to be ready and upskill to prepare for emerging technologies. The ethical, regulatory, and educational frameworks surrounding artificial intelligence and precision medicine will require constant attention, but the potential benefits for patient outcomes are unprecedented. Clinical pharmacists are in a prime position to design a new era in precision medicine, where technology works hand in hand with humans to transform healthcare.
在人工智能代理、自动化、数据分析和机器人技术的推动下,临床药学正处于指数级变化的尖端。区块链将增强数据的完整性和透明度,增强现实和虚拟现实技术将彻底改变培训、患者教育和基于模拟的护理计划。临床药师需要做好准备,提高技能,为新兴技术做好准备。围绕人工智能和精准医疗的伦理、监管和教育框架需要持续关注,但对患者预后的潜在好处是前所未有的。临床药剂师处于设计精准医疗新时代的首要位置,在这个时代,技术与人类携手并进,改变医疗保健。
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引用次数: 0
Mapping research themes and future directions in tuberculosis stigma: a bibliometric and content analysis 肺结核病耻感的研究主题和未来方向:文献计量学和内容分析
Pub Date : 2025-09-01 DOI: 10.1016/j.glohj.2025.10.002
Desy Sulistiyorini , Mustopa , Zahiruddin Othman

Objective

This study has the objective to offer a thorough overview of the current state and future research possibilities regarding the social stigma of tuberculosis (TB). Given the growing volume and variety of research in this field, a quantitative approach is essential for mapping existing themes and pinpointing potential areas for further investigation. To accomplish this, a bibliometric and content analysis was performed to explore the current literature and emphasize key themes and future directions.

Methods

The study examines 770 bibliographic records from Scopus and visualizes the results of the bibliometric analysis using co-occurrence and thematic map analyses with VOSviewer and Tableau Public software. Additionally, a content analysis was conducted based on the findings from the co-occurrence analysis.

Results

The findings indicate a notable rise in publications and citations related to the social stigma of TB, with prominent research topics including healthcare workers, social support, mobile health technology (mHealth), nursing, and attitudes. Emerging areas of research encompass epidemiology, public health, patient delays, multidrug-resistant TB (MDR-TB), corona virus disease 2019, and mHealth. Future studies might concentrate on the factors leading to patient delays, as well as the development of diagnostic tools and effective treatment regimens for MDR-TB cases.

Conclusion

This study offers important insights into the current state of social stigma in TB research and identifies promising areas for future investigation. By addressing these research gaps and refining methodological approaches, researchers can strengthen initiatives to combat TB stigma, ultimately resulting in more effective treatments and improved adherence among TB patients.
本研究的目的是全面概述结核病(TB)的社会耻辱的现状和未来的研究可能性。鉴于这一领域的研究数量和种类不断增加,定量方法对于绘制现有主题和确定进一步调查的潜在领域至关重要。为了实现这一目标,进行了文献计量学和内容分析,以探索当前文献并强调关键主题和未来方向。方法对Scopus数据库中的770条文献记录进行分析,利用VOSviewer和Tableau Public软件对文献计量学分析结果进行共现和专题图分析。此外,根据共现分析的结果进行了内容分析。结果研究结果表明,与结核病的社会污名相关的出版物和引用显著增加,突出的研究主题包括卫生保健工作者、社会支持、移动卫生技术(mHealth)、护理和态度。新兴研究领域包括流行病学、公共卫生、患者延误、耐多药结核病(MDR-TB)、2019冠状病毒病和移动健康。未来的研究可能会集中在导致患者延误的因素,以及开发针对耐多药结核病病例的诊断工具和有效治疗方案。结论本研究对结核病研究中的社会污名现状提供了重要见解,并确定了未来研究的有希望的领域。通过解决这些研究差距和改进方法方法,研究人员可以加强消除结核病耻辱感的举措,最终实现更有效的治疗并改善结核病患者的依从性。
{"title":"Mapping research themes and future directions in tuberculosis stigma: a bibliometric and content analysis","authors":"Desy Sulistiyorini ,&nbsp;Mustopa ,&nbsp;Zahiruddin Othman","doi":"10.1016/j.glohj.2025.10.002","DOIUrl":"10.1016/j.glohj.2025.10.002","url":null,"abstract":"<div><h3>Objective</h3><div>This study has the objective to offer a thorough overview of the current state and future research possibilities regarding the social stigma of tuberculosis (TB). Given the growing volume and variety of research in this field, a quantitative approach is essential for mapping existing themes and pinpointing potential areas for further investigation. To accomplish this, a bibliometric and content analysis was performed to explore the current literature and emphasize key themes and future directions.</div></div><div><h3>Methods</h3><div>The study examines 770 bibliographic records from Scopus and visualizes the results of the bibliometric analysis using co-occurrence and thematic map analyses with VOSviewer and Tableau Public software. Additionally, a content analysis was conducted based on the findings from the co-occurrence analysis.</div></div><div><h3>Results</h3><div>The findings indicate a notable rise in publications and citations related to the social stigma of TB, with prominent research topics including healthcare workers, social support, mobile health technology (mHealth), nursing, and attitudes. Emerging areas of research encompass epidemiology, public health, patient delays, multidrug-resistant TB (MDR-TB), corona virus disease 2019, and mHealth. Future studies might concentrate on the factors leading to patient delays, as well as the development of diagnostic tools and effective treatment regimens for MDR-TB cases.</div></div><div><h3>Conclusion</h3><div>This study offers important insights into the current state of social stigma in TB research and identifies promising areas for future investigation. By addressing these research gaps and refining methodological approaches, researchers can strengthen initiatives to combat TB stigma, ultimately resulting in more effective treatments and improved adherence among TB patients.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"9 3","pages":"Pages 228-237"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145750368","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}
引用次数: 0
Impact of long-term environmental toxin exposure on prepubertal boys' anthropometric and hormonal development 长期环境毒素暴露对青春期前男孩人体测量和激素发育的影响
Pub Date : 2025-09-01 DOI: 10.1016/j.glohj.2025.10.003
Valery Erkudov , Kenjabek Rozumbetov , Shanika Arachchi , Upaka Rathnayake , Azat Matchanov , Andrey Pugovkin , Sergey Lytaev

Background

Long-term exposure to toxic substances increases the risk of their accumulation and triggering endocrine disruption. The ill-planned irrigation systems in Uzbekistan led to severe environmental disasters, resulting in aridization and the spread of organochlorine pesticides and toxic metals across the region.

Objective

We investigate the influence of negative environmental factors on hormonal activities such as sex steroids, gonadotropic hormones, and growth factors, in addition to potential disruptions in growth rate and anthropometric indicators in prepubertal adolescents living in this region.

Methods

This study included 405 prepubertal boys aged 11 to 13 years, residing in the cities of Muynak (unfavorable region) and Nukus (favorable region) of Uzbekistan. We measured 20 anthropometric parameters and assessed somatotype by the Heath–Carter method, peak height velocity (PHV), and maturity offset based on Mirwald's equation. In addition, the endocrine profile of 8 hormonal parameters was assessed, which includes growth factors, gonadotropins, sex steroids, and thyroid status.

Results

We observed a positive dependence of physique, rate of maturation, and level of androgens, stimulated by gonadotropin hormones. Children living in unfavorable environmental regions show a decrease in follicle-stimulating hormone, luteinizing hormone, total testosterone (the best predictor), and anthropometric signs of androgen deficiency. These resulted in an increase in maturity offset and PHV, combined with lower skeletal density and ectomorphic somatotype compared to their peers living in favorable environmental regions.

Conclusion

Regional differences in stature, body weight, and anthropometric parameters of adipose tissue, growth factor axis, and thyroid hormones are the influencing indices in the regulation of growth in prepubertal children. We hypothesize that the inhibition of the gonadotropin-testosterone axis may result from endocrine disruption due to higher levels of toxic metals and pesticide exposure.
长期接触有毒物质会增加其积累和引发内分泌紊乱的风险。乌兹别克斯坦规划不周的灌溉系统导致了严重的环境灾害,导致干旱化,有机氯农药和有毒金属在整个地区蔓延。目的探讨负面环境因素对性激素、促性腺激素和生长因子等激素活动的影响,以及对该地区青春期前青少年生长速度和人体测量指标的潜在干扰。方法对居住在乌兹别克斯坦Muynak市(不利地区)和Nukus市(有利地区)的11 ~ 13岁的青春期前男孩405例进行研究。我们测量了20个人体测量参数,并通过Heath-Carter法、峰高速度(PHV)和基于Mirwald方程的成熟度偏移来评估体型。此外,还评估了8种激素参数的内分泌特征,包括生长因子、促性腺激素、性类固醇和甲状腺状态。结果我们观察到,在促性腺激素的刺激下,体质、成熟速度和雄激素水平呈正相关。生活在不利环境地区的儿童表现出卵泡刺激素、黄体生成素、总睾酮(最佳预测因子)和雄激素缺乏的人体测量指标的下降。与生活在有利环境地区的同龄人相比,这些导致了成熟偏移和PHV的增加,同时骨骼密度和生态型体型也较低。结论身高、体重、脂肪组织、生长因子轴、甲状腺激素等人体测量参数的区域差异是影响青春期前儿童生长调节的指标。我们假设促性腺激素-睾酮轴的抑制可能是由于较高水平的有毒金属和农药暴露导致的内分泌干扰。
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引用次数: 0
A scoping review of maternal mortality, its health determinants, and factors that influence care utilization in women of child-bearing years in Nigeria 对尼日利亚产妇死亡率、其健康决定因素和影响育龄妇女利用护理的因素进行范围审查
Pub Date : 2025-09-01 DOI: 10.1016/j.glohj.2025.10.004
Sarah Ifunaya Anumudu , Chijioke Christopher Uhegwu , Christian Kosisochukwu Anumudu

Objectives

This scoping review aims to methodically identify and analyse the determinants which influence maternal mortality and healthcare utilization in women of childbearing years in Nigeria. The review specifically addresses the difficulties faced in assessing medical care, and the ongoing initiatives to lower the maternal mortality ratio.

Methods

Primary studies (published after year 2000) focused on maternal mortality, health determinants, and the utilization of maternal healthcare services in Nigeria were retrieved following a systematic search across multiple databases, including Scopus, PubMed, Google Scholar, and Web of Science. These were screened using defined inclusion and exclusion criteria. Data from these studies were extracted and thematically analysed to identify common themes and trends.

Results

A total of 21 publications were included in this review comprising 2 qualitative, 17 quantitative, and 2 mixed study designs. Major health determinants identified in these studies include hypertensive disorders of pregnancy, haemorrhage, and sepsis/septicaemia, contributing as much as 29 %, 24 %, and 14.2 % of maternal deaths respectively in over 10 % of the reviewed studies. Similarly, social-economic determinants including poverty, maternal education, health system issues and culture significantly impacted the utilization of maternal healthcare services, inadvertently impacting maternal mortality. Despite various maternal health interventions such as the “Abiye” Safe Motherhood Initiative, the Integrated Maternal, Newborn, and Child Health Strategy and strengthening emergency obstetric care by governmental and non-governmental agencies, early childbearing, unemployment, large family sizes, and dependence on male spouses continued to result in suboptimal utilization of services and adverse maternal outcomes.

Conclusion

This scoping review comprehensively integrated existing data from published studies to provide a detailed picture of maternal mortality, its health determinants, and factors influencing care utilization among women of childbearing age in Nigeria and approaches to reduce maternal mortality in the country and possibly in the West African sub-region.
本范围审查旨在系统地确定和分析影响尼日利亚产妇死亡率和育龄妇女保健利用的决定因素。审查特别讨论了在评估医疗保健方面面临的困难,以及正在采取的降低产妇死亡率的举措。方法通过对多个数据库(包括Scopus、PubMed、谷歌Scholar和Web of Science)的系统检索,检索了主要关注尼日利亚孕产妇死亡率、健康决定因素和孕产妇保健服务利用情况的初步研究(2000年以后发表)。使用明确的纳入和排除标准对这些患者进行筛选。从这些研究中提取数据并进行主题分析,以确定共同的主题和趋势。结果本综述共纳入21篇文献,包括2篇定性研究、17篇定量研究和2篇混合研究。在这些研究中确定的主要健康决定因素包括妊娠高血压疾病、出血和败血症/败血症,在超过10%的审查研究中,它们分别占孕产妇死亡的29%、24%和14.2%。同样,包括贫困、孕产妇教育、卫生系统问题和文化在内的社会经济决定因素对孕产妇保健服务的利用产生了重大影响,无意中影响了孕产妇死亡率。尽管采取了各种孕产妇保健干预措施,如“阿比耶”安全孕产倡议、孕产妇、新生儿和儿童综合保健战略以及加强政府和非政府机构的紧急产科护理,但早育、失业、家庭规模大以及对男性配偶的依赖继续导致服务利用不佳和孕产妇不良后果。这项范围审查全面整合了已发表研究的现有数据,提供了尼日利亚孕产妇死亡率、其健康决定因素和影响育龄妇女护理利用的因素的详细情况,以及降低该国乃至西非次区域孕产妇死亡率的方法。
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引用次数: 0
Co-morbidity of malaria and hypertension among adults in Nigeria: patterns, mechanisms, and health barriers 尼日利亚成年人中疟疾和高血压的合并症:模式、机制和健康障碍
Pub Date : 2025-09-01 DOI: 10.1016/j.glohj.2025.10.005
Ufuomanefe Cleopatra Omoemu , Modupe Oluwatemitope Oyedele , Boluwatife Samuel Awe , Kamara Alfred Osman , Fidelis Ogenetega Ejeheri

Objective

This review examined the co-morbidity of malaria and hypertension in Nigerian adults, with a focus on epidemiological trends, genetic and environmental risk factors, pathophysiological mechanisms, and systemic healthcare barriers.

Methods

A qualitative synthesis of peer-reviewed literature, national health surveys, and institutional reports published between 2000 and 2025 was conducted using thematic analysis. While centered on Nigeria, the review incorporated comparative insights from global studies on renin angiotensin aldosterone system polymorphisms, co-infection dynamics, and health service inequalities.

Results

The findings indicate overlapping risk factors including renin angiotensin aldosterone system gene polymorphisms, urbanization, and poverty. Angiotensin II demonstrates dual functions, contributing both to malaria suppression and to hypertension pathogenesis. Clinical challenges include diagnostic overlap, adverse drug interactions, and disparities in service delivery between rural and urban populations. These challenges particularly affect older adults and highlight systemic gaps in access, workforce distribution, and policy alignment.

Conclusion

The dual burden of malaria and hypertension in Nigeria requires integrated disease management strategies that address both communicable and non-communicable disease risks. Urgent priorities include multi-sectoral policy reforms, expanded rural health investments, and the adoption of precision medicine approaches guided by genetic profiling. The implications extend to clinical practice through co-screening and tailored treatment protocols and to public health policy, where integrated frameworks are essential to reducing inequities and improving long-term outcomes.
目的研究尼日利亚成年人疟疾和高血压的合并症,重点关注流行病学趋势、遗传和环境危险因素、病理生理机制和系统性卫生保健障碍。方法采用专题分析方法,对2000年至2025年间发表的同行评议文献、国家卫生调查和机构报告进行定性综合。虽然以尼日利亚为中心,但该综述纳入了肾素血管紧张素醛固酮系统多态性、合并感染动态和卫生服务不平等等全球研究的比较见解。结果肾素血管紧张素醛固酮系统基因多态性、城市化和贫困等因素重叠。血管紧张素II具有双重功能,既有助于抑制疟疾,又有助于高血压发病。临床挑战包括诊断重叠、药物不良相互作用以及城乡人口之间服务提供的差异。这些挑战尤其影响老年人,并突出了在获取、劳动力分布和政策协调方面的系统性差距。结论尼日利亚的疟疾和高血压双重负担需要采取综合疾病管理战略,同时应对传染病和非传染性疾病风险。紧迫的优先事项包括多部门政策改革、扩大农村卫生投资以及采用以基因图谱为指导的精准医疗方法。其影响通过联合筛查和量身定制的治疗方案扩展到临床实践,并扩展到公共卫生政策,在公共卫生政策中,综合框架对于减少不平等和改善长期成果至关重要。
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引用次数: 0
Access to health services and factors affecting musculoskeletal disorders among outdoor pollution workers following Sustainable Development Goals: a weakness in Thailand 可持续发展目标后室外污染工人获得卫生服务的机会和影响肌肉骨骼疾病的因素:泰国的弱点
Pub Date : 2025-06-01 DOI: 10.1016/j.glohj.2025.06.002
Anamai Thetkathuek , Marissa Kongsombatsuk , Teeranun Nakyai , Chan Pattama Polyong

Background

People working outdoors in the Map Ta Phut pollution control area of Thailand require comprehensive health monitoring. In the past, studies have been done on the health effects of pollutants. However, there are few studies on musculoskeletal disorders (MSDs), and Thailand is struggling to meet the Sustainable Development Goals.

Methods

This cross-sectional study examines access to health services and factors affecting MSDs among outdoor pollution workers (OPWs). The sample group includes OPWs, including local fisherman, street vendors, public car drivers, and traffic police. We studied 50 people from each of these groups, for a total of 200 people. Data were analyzed with inferential statistics using Chi-square test, McNemar test, and Univariate logistic regression.

Results

The OPWs reported experiencing significantly more total MSDs pain than they did in the past (P < 0.05). Factors affecting current MSDs pain, including occupation and working days per week, were significant (P < 0.05). The street vendor group and public car driver group had (odds ratio [OR] = 2.253, 95 % confidence interval [CI]: 1.101 to 5.019) and (OR = 2.681, 95 % CI: 1.191 to 6.032) times higher risks of MSDs pain, respectively. OPWs who work > 5 days per week had a (OR = 1.464, 95 % CI: 1.093 to 2.704) times higher risk of MSDs pain. 52.7 % of OPWs with MSDs, pain (n = 110) had received an annual health check-up. In the past year, 50.9 % had minor illnesses and 21.8 % had severe illnesses. OPWs receiving free treatment and visiting health service stations for no cost comprised 77.3 % and 51.8 %, respectively. 60.9 % used their right to receive treatment with universal health insurance cards.

Conclusions

The study indicates that occupational groups with MSDs pain problems should exercise this right, according to the worker protection law. Local health agencies should organize activities or create accessible media to promote preventive medicine services, as many OPWs believe that health services can only be accessed when illness occurs.
背景:在泰国Map Ta Phut污染控制区从事户外工作的人员需要进行全面的健康监测。在过去,已经对污染物对健康的影响进行了研究。然而,关于肌肉骨骼疾病(MSDs)的研究很少,泰国正在努力实现可持续发展目标。方法本横断面研究调查了室外污染工人(opw)获得卫生服务和影响MSDs的因素。样本群体包括opw,包括当地渔民、街头小贩、公共汽车司机和交通警察。我们研究了每组50人,总共200人。资料采用卡方检验、McNemar检验和单因素logistic回归进行推理统计分析。结果opw报告的msd总疼痛比过去明显增加(P <;0.05)。影响当前MSDs疼痛的因素,包括职业和每周工作天数,具有显著性(P <;0.05)。街头小贩组和公共汽车司机组分别(比值比[OR] = 2.253, 95%可信区间[CI]: 1.101 ~ 5.019)和(比值比[OR] = 2.681, 95%可信区间[CI]: 1.191 ~ 6.032)是MSDs疼痛风险的两倍。工作>;每周5天的MSDs疼痛风险(OR = 1.464, 95% CI: 1.093 ~ 2.704)高出1倍。有MSDs、疼痛的opw (n = 110)中有52.7%接受过年度健康检查。在过去一年中,50.9%的人患有轻微疾病,21.8%的人患有严重疾病。接受免费治疗和免费前往保健服务站的opw分别占77.3%和51.8%。60.9%的人利用全民健康保险卡接受治疗的权利。结论有MSDs疼痛问题的职业群体应根据《工人保护法》行使这一权利。地方卫生机构应组织活动或创建无障碍媒体,以促进预防医学服务,因为许多门诊医生认为,只有在生病时才能获得卫生服务。
{"title":"Access to health services and factors affecting musculoskeletal disorders among outdoor pollution workers following Sustainable Development Goals: a weakness in Thailand","authors":"Anamai Thetkathuek ,&nbsp;Marissa Kongsombatsuk ,&nbsp;Teeranun Nakyai ,&nbsp;Chan Pattama Polyong","doi":"10.1016/j.glohj.2025.06.002","DOIUrl":"10.1016/j.glohj.2025.06.002","url":null,"abstract":"<div><h3>Background</h3><div>People working outdoors in the Map Ta Phut pollution control area of Thailand require comprehensive health monitoring. In the past, studies have been done on the health effects of pollutants. However, there are few studies on musculoskeletal disorders (MSDs), and Thailand is struggling to meet the Sustainable Development Goals.</div></div><div><h3>Methods</h3><div>This cross-sectional study examines access to health services and factors affecting MSDs among outdoor pollution workers (OPWs). The sample group includes OPWs, including local fisherman, street vendors, public car drivers, and traffic police. We studied 50 people from each of these groups, for a total of 200 people. Data were analyzed with inferential statistics using Chi-square test, McNemar test, and Univariate logistic regression.</div></div><div><h3>Results</h3><div>The OPWs reported experiencing significantly more total MSDs pain than they did in the past (<em>P</em> &lt; 0.05). Factors affecting current MSDs pain, including occupation and working days per week, were significant (<em>P</em> &lt; 0.05). The street vendor group and public car driver group had (odds ratio [<em>OR</em>] = 2.253, 95 % confidence interval [<em>CI</em>]: 1.101 to 5.019) and (<em>OR</em> = 2.681, 95 % <em>CI</em>: 1.191 to 6.032) times higher risks of MSDs pain, respectively. OPWs who work &gt; 5 days per week had a (<em>OR</em> = 1.464, 95 % <em>CI</em>: 1.093 to 2.704) times higher risk of MSDs pain. 52.7 % of OPWs with MSDs, pain (<em>n</em> = 110) had received an annual health check-up. In the past year, 50.9 % had minor illnesses and 21.8 % had severe illnesses. OPWs receiving free treatment and visiting health service stations for no cost comprised 77.3 % and 51.8 %, respectively. 60.9 % used their right to receive treatment with universal health insurance cards.</div></div><div><h3>Conclusions</h3><div>The study indicates that occupational groups with MSDs pain problems should exercise this right, according to the worker protection law. Local health agencies should organize activities or create accessible media to promote preventive medicine services, as many OPWs believe that health services can only be accessed when illness occurs.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"9 2","pages":"Pages 85-93"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703755","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}
引用次数: 0
Occupational influences on dietary quality among postpartum women: a cross-sectional study in Beijing, China 职业对产后妇女饮食质量的影响:北京地区的一项横断面研究
Pub Date : 2025-06-01 DOI: 10.1016/j.glohj.2025.06.003
Jian Zhao, Min Zhang

Objective

Postpartum nutrition plays a critical role in maternal recovery and long-term health. However, the nutritional status of working mothers in the postpartum period remains understudied. This study aimed to assess the dietary quality of postpartum women in urban Beijing, identify occupational-related factors influencing their diet, and explore potential interventions to improve maternal nutrition during the postpartum period.

Methods

In this cross-sectional analysis, 554 women one year after delivery were recruited from ten community health centers. Sociodemographic, occupational and postpartum care variables were collected via questionnaire. Dietary intake over the preceding year was assessed using a food frequency questionnaire. The modified dietary balance index for postpartum women were used for dietary quality assessment.

Results

The study revealed severe dietary imbalances among postpartum women, characterized by excessive consumption of cereals, eggs, and meats, while their intake of vegetables, fruits, and dairy products was inadequate. According to dietary balance index for postpartum women, 66.25 % of mothers showed varying degrees of excessive intake. 45.31 % of mothers experienced varying levels of insufficient intake, with only 19.86 % of participants having a relatively balanced diet. Occupational differences were observed, with women in the commercial employment group showing higher levels of excessive food intake. The analysis of influencing factors showed that family monthly income, maternity leave, and postpartum care significantly affected the dietary quality.

Conclusions

Postpartum women in Beijing experience widespread dietary imbalances, with both excesses and deficiencies. Occupational context and related factors significantly shape diet quality. These findings highlight the need for targeted nutritional interventions tailored to the specific challenges of different occupational groups.
目的产后营养对产妇的康复和长期健康起着至关重要的作用。然而,职业母亲在产后期间的营养状况仍未得到充分研究。本研究旨在评估北京城市产后妇女的饮食质量,识别影响其饮食的职业相关因素,并探讨改善产后产妇营养的潜在干预措施。方法在横断面分析中,从10个社区卫生中心招募了554名分娩后一年的妇女。通过问卷调查收集社会人口学、职业和产后护理变量。使用食物频率问卷对前一年的饮食摄入量进行评估。采用改良后的产后妇女膳食平衡指数进行膳食质量评价。结果研究揭示了产后妇女严重的饮食失衡,其特点是过量食用谷物、鸡蛋和肉类,而蔬菜、水果和乳制品的摄入量不足。根据产后妇女膳食平衡指数,66.25%的母亲表现出不同程度的过量摄入。45.31%的母亲有不同程度的摄入不足,只有19.86%的参与者有相对均衡的饮食。观察到职业差异,商业就业组的妇女表现出更高水平的过度食物摄入。影响因素分析显示,家庭月收入、产假、产后护理对饮食质量有显著影响。结论北京地区产后妇女普遍存在膳食失衡,既有过量,也有不足。职业环境及相关因素对饮食质量有显著影响。这些发现突出表明,需要针对不同职业群体的具体挑战采取有针对性的营养干预措施。
{"title":"Occupational influences on dietary quality among postpartum women: a cross-sectional study in Beijing, China","authors":"Jian Zhao,&nbsp;Min Zhang","doi":"10.1016/j.glohj.2025.06.003","DOIUrl":"10.1016/j.glohj.2025.06.003","url":null,"abstract":"<div><h3>Objective</h3><div>Postpartum nutrition plays a critical role in maternal recovery and long-term health. However, the nutritional status of working mothers in the postpartum period remains understudied. This study aimed to assess the dietary quality of postpartum women in urban Beijing, identify occupational-related factors influencing their diet, and explore potential interventions to improve maternal nutrition during the postpartum period.</div></div><div><h3>Methods</h3><div>In this cross-sectional analysis, 554 women one year after delivery were recruited from ten community health centers. Sociodemographic, occupational and postpartum care variables were collected via questionnaire. Dietary intake over the preceding year was assessed using a food frequency questionnaire. The modified dietary balance index for postpartum women were used for dietary quality assessment.</div></div><div><h3>Results</h3><div>The study revealed severe dietary imbalances among postpartum women, characterized by excessive consumption of cereals, eggs, and meats, while their intake of vegetables, fruits, and dairy products was inadequate. According to dietary balance index for postpartum women, 66.25 % of mothers showed varying degrees of excessive intake. 45.31 % of mothers experienced varying levels of insufficient intake, with only 19.86 % of participants having a relatively balanced diet. Occupational differences were observed, with women in the commercial employment group showing higher levels of excessive food intake. The analysis of influencing factors showed that family monthly income, maternity leave, and postpartum care significantly affected the dietary quality.</div></div><div><h3>Conclusions</h3><div>Postpartum women in Beijing experience widespread dietary imbalances, with both excesses and deficiencies. Occupational context and related factors significantly shape diet quality. These findings highlight the need for targeted nutritional interventions tailored to the specific challenges of different occupational groups.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"9 2","pages":"Pages 94-103"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703756","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}
引用次数: 0
期刊
Global health journal (Amsterdam, Netherlands)
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