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Rapid detection of antibiotic resistance in Burkholderia pseudomallei using MALDI-TOF mass spectrometry.
Get PDFAntibiotic resistance in Burkholderia pseudomallei (Bp) is a growing public health concern requiring urgent attention. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) has emerged as a rapid bacterial identification tool with potential for future diagnostic applications. This study investigates differences in MALDI-TOF spectra of antibiotic-resistant Bp strains from northeastern Thailand without any pretreatment steps. A total of 300 Bp isolates were tested for minimum inhibitory concentration (MIC) values against five antibiotics: ceftazidime, meropenem, imipenem, co-amoxiclav, and co-trimoxazole. MALDI-TOF spectra were obtained using the direct colony method and analysed for correlations with antibiotic resistance patterns. Thirteen isolates exhibited resistance based on CLSI breakpoints, with most showing low-level MICs across all tested antibiotics. MALDI-TOF MS analysis revealed clustering patterns associated with resistance. A decision tree algorithm identified ten significant peaks that effectively distinguished resistant isolates. This study highlights MALDI-TOF MS as a rapid and reliable tool for detecting antibiotic resistance, offering timely results to support treatment decisions and streamline microbiology workflows
Alcohol industry conflicts of interest: The pollution pathway from misinformation to alcohol harms.
Get PDFThe alcohol industry plays a major role in global public health harm, and shapes policies and public perceptions to its benefit, through misinformation, lobbying and self-regulation. This article describes the alcohol industry's conflicts of interest, particularly in the dissemination of misleading health information, its role in school-based alcohol 'education', and its resistance to evidence-based harm reduction measures. The industry's activities contribute to a 'pollution pathway' that normalises alcohol consumption while obscuring its links to cancer, cardiovascular disease, fetal alcohol spectrum disorders (FASD) and other harms. Alcohol industry-funded organisations, such as Drinkaware, omit and distort the evidence on health risks and seek to shift the responsibility for harm onto consumers. Drawing parallels with the tobacco industry, we argue for stricter regulation, exclusion of the alcohol industry from health policymaking, and stronger public awareness campaigns to counter alcohol industry misinformation. Urgent action is needed to protect public health from alcohol industry influence and to mitigate alcohol-related harm
Feeling lonely in the online crowd: what TikTok tells us about young people and loneliness.
Get PDFLoneliness is a pressing public health issue, with young people particularly affected. Given the widespread use of TikTok among younger demographics, the platform plays an influential role in shaping perceptions of health topics. This study examines the self-perceived causes and experiences of loneliness expressed by TikTok users. We built a dataset of the most popular, publicly available English-language TikTok videos globally that used the hashtag #lonely and performed a qualitative content analysis to assess (i) video tone, (ii) self-expressed identities related to loneliness, (iii) unmet desires expressed as the cause of loneliness, (iii) absences expressed as the cause of loneliness, and (v) changes in life circumstance as the cause of loneliness. The included videos (n = 184) generated over 687 million views. Absence (69.6%) was the prevailing theme of self-perceived causes of loneliness. This absence was mostly attributed to a lack of quality in a person's relationships (33.7%) or having no relationship (32.1%). Mental health (26.1%) was the most cited expression of identity related to the experience of loneliness. The overall sentiment of the videos was negative (83.2%). No videos were made by healthcare professionals or healthcare organizations offering health information or support. TikTok is an accessible, underutilized, and valuable data resource to understand the public portrayal and sentiment of pressing health topics in young people. Results reveal a prevalence of negatively toned videos, primarily expressing absence as a root cause of loneliness
Knowledge, Attitudes, and Practices toward Chagas Disease: A Cross-Sectional Survey of Bolivians in the Gran Chaco and Latin American Migrants in London.
Get PDFUnderstanding the at-risk population's perception of Chagas disease is essential for its effective prevention and control. A cross-sectional survey of knowledge, attitudes, and practices toward Chagas disease was conducted with Bolivians in a highly endemic region of Bolivia and Latin American migrants in London. In total, 175 participants completed the survey: 100 Bolivians in a highly endemic village in Santa Cruz, Bolivia and 75 Latin American migrants in London (of whom 31 were from Bolivia). All participants from the endemic village and all Bolivian migrants in London knew of Chagas disease, whereas only 25% of other Latin American migrants had heard of it (P <0.001). In London, Bolivians had more knowledge of Chagas disease than those from other Chagas-endemic countries. In Bolivia only, better understanding of Chagas disease was associated with educational attainment. Only 4% of participants overall were aware of the risk of vertical transmission. Few Latin American migrants in London had previously been tested for Chagas disease, and most were not aware of how to access testing. Migration and level of endemicity may shape individuals' understanding of as well as attitudes and practices toward Chagas disease. A better understanding of these factors can guide effective prevention and control program development in both endemic and non-endemic settings
School Meals Case Study: Brazil School Meals Case Study: Brazil [Estudo de caso de alimentação escolar: Brasil].
Get PDFEste Estudo de Caso de Alimentação Escolar faz parte de uma coleção liderada pela Comunidade de Prática dos “Bons Exemplos” do Consórcio de Pesquisa para a Saúde e Nutrição Escolar. O Estudo de Caso de Alimentação Escolar do Brasil tem como objetivo documentar como o programa nacional de alimentação escolar é organizado, financiado e monitorado em todo o país. Os objetivos deste estudo de caso incluem apresentar uma introdução ao perfil do país, descrever o desenho e a implementação dos programas de alimentação escolar, detalhar seus processos de monitoramento e avaliação, e destacar as lições aprendidas, as boas práticas e os desafios enfrentados. Este estudo de caso é redigido como um documento de trabalho e pode ser atualizado para refletir circunstâncias em evolução. A Comunidade de Prática dos “Bons Exemplos” apoia a geração de evidências do Consórcio de Pesquisa para a Saúde e Nutrição Escolar, que é o braço de produção de evidências da Coalizão para a Alimentação Escolar. O objetivo do Consórcio de Pesquisa é realizar pesquisas independentes em diversos setores e gerar evidências sólidas, convincentes e acionáveis sobre os benefícios dos programas de alimentação escolar, a fim de informar a tomada de decisões baseada em evidências nas políticas e práticas de saúde e nutrição escolar.
This school meals case study forms part of a collection led by the Research Consortium for School Health and Nutrition’s "Good Examples" Community of Practice. The School Meals Case Study of Brazil serves to document how the national school meals programme is organized, funded, and monitored throughout the country. The objectives of this case study include presenting an introduction to the country profile, outlining the design and implementation of school feeding programmes, describing their monitoring and evaluation processes, and highlighting lessons learned, best practices, and challenges. This case study is written as a working paper, and can be updated to reflect evolving circumstances. The ‘Good Examples’ Community of Practice supports the evidence generation of the Research Consortium for School Health and Nutrition, the evidence-generating arm of the School Meals Coalition. The Research Consortium’s objective is to carry out independent research across diverse sectors and generate solid, compelling, and actionable evidence regarding the benefits of school food programs to inform evidence-based decision-making on school health and nutrition policies and practices
Creating a Usable and Effective Digital Intervention to Support Men to Test for HIV and Link to Care in A Resource-Constrained Setting: Iterative Design Based on A Person-Based Approach and Human Computer Interaction Methods.
Get PDFBACKGROUND: It is challenging to design usable and effective digital health interventions (DHIs). The person-based approach (PBA) has been proposed to incorporate users' perspectives for the design of DHIs. However, it does not explicitly describe the iterative stages of design and evaluation that are essential in moving from early planning to deployment. For this, we draw on methods from human computer interaction (HCI) that have been developed for various situations. OBJECTIVE: This study aimed to reflect on the adaptation and synthesis of PBA and HCI approaches to developing DHIs. We present a case study applying both approaches to develop Empowering People through Informed Choices for HIV (EPIC-HIV1), a DHI designed for men living in rural KwaZulu-Natal, South Africa, intended to support them in making an informed choice about whether to take an HIV test and, if necessary, engage in care. METHODS: We conducted a retrospective analysis of the documentation generated during the development of EPIC-HIV1 including findings about requirements, design representations, and the results of iterative rounds of testing. We developed an account of the process, the outcomes, and the strengths and limitations of the design and evaluation techniques applied. We also present the design of EPIC-HIV1 and summarize considerations when designing for hard-to-reach people in such settings. RESULTS: The PBA was applied to deliver a first prototype. This helped identify key messages to convey and how to manage issues such as user privacy, but the resulting prototype was judged by the team not to be engaging for potential users, and it was unclear whether the design was inclusive of people with low digital or health literacy. We therefore introduced methods from HCI to iteratively test and refine the app. Working with local community representatives, we conducted four refinement cycles with 29 participants, adapting and retesting the app until no further changes were needed. Key changes included making it clearer what the consequences of selecting options in the app were and changing wording to minimize misconceptions (eg, that the app would test for HIV) while addressing common concerns about testing and emphasizing long-term benefits of engaging with care, if needed. CONCLUSIONS: Techniques for developing DHIs need to be situationally appropriate. The PBA enabled us to establish both empirical data and theory to design the content of EPIC-HIV1, but it did not directly inform interaction design to make the app usable and effective for the intended users; HCI techniques tailored to the setting enabled us to refine the app to be easy for men with little familiarity with digital technologies to use within the constraints of the setting. Iterative testing ensured the app was easy to use and that the intended clinical messages were communicated effectively
A global meta-analysis of gonorrhoea and chlamydia prevalence among men who have sex with men from 2000 to 2022.
Get PDFIntroductionWe conducted a global systematic review and meta-analysis of gonorrhoea and chlamydia among men who have sex with men (MSM) from 2000 to 2022.MethodsWe searched four databases to identify studies conducted between 1 January 2000 and 19 April 2022 that reported prevalence from aetiological assays. We extracted data, calculated point estimates, corrected and then pooled them using random-effects models. We stratified results by United Nations regions and conducted subgroup analyses established apriori.Results172 studies met our inclusion criteria, providing 387 prevalence data points from 57 countries. The overall pooled prevalence for gonorrhoea was 7.2% [95% CI: 6.0 to 8.5; 188 data points; n = 347,253] and for chlamydia was 9.9% (95% CI: 8.8 to 11.0; 190 data points; n = 342,799). For gonorrhoea, pooled prevalence between 2000 and 2010 was 5.0% (95% CI: 3.7 to 6.5; 89 data points; n = 78,557) compared to 9.3% (7.7-11.1; 99 data points; n = 268,696) between 2011 and 2022, p < 0.001. For chlamydia, pooled prevalence between 2000 to 2010 was 6.6% (95% CI: 5.4 to 7.9; 95 data points; n = 91,015) compared to 13.6% (12.0-15.2; 95 data points; n = 251,784) between 2011 and 2022, p < 0.001.ConclusionA holistic approach is needed to reduce the curable STIs burden among MSM
Disability-inclusive graduation programme intervention on social participation among ultra-poor people with disability in North Uganda: a cluster randomized trial.
Get PDFBACKGROUND: People with disabilities encounter significant barriers to social participation due to inaccessible environments and negative attitudes. This study evaluated the effectiveness of a comprehensive disability-inclusive graduation (DIG) programme in enhancing social participation among ultra-poor people with disabilities in rural Uganda. METHODS: A two-arm, cluster-randomized controlled trial was conducted in four Northern Ugandan districts, involving 96 intervention and 89 control clusters. The DIG intervention encompassed four pillars: Livelihoods, Social Protection, Financial Inclusion, and Social Empowerment. The study identified households with disabilities using the Washington Group Short Set questions, verified by BRAC programme managers, comprising 370 working-age people with disabilities in the intervention group and 321 in the control group at baseline. Treatment clusters received an 18-month DIG intervention from December 2020 to June 2022. Social participation was measured using the SINTEF Participation Question Set at baseline, immediately post-intervention, and 16 months post-intervention, covering household and societal participation domains. Intervention effects were analyzed through linear mixed-effects regression models, reporting minimally adjusted and fully adjusted mean differences (MAMD and FAMD) with 95% confidence intervals. RESULTS: Immediately after the intervention, the DIG programme showed a positive trend in overall social participation (3.04 point increase in intervention group vs. - 0.29 in control), though not statistically significant in fully adjusted analysis (FAMD = 3.14, 95% CI = (- 1.26, 7.54); p = 0.17), possibly due to sample size limitations and variability in individual responses. A larger improvement in societal participation was observed favouring the intervention group (5.92 point increase versus 0.21 in control), with the fully adjusted analysis approaching statistical significance (FAMD = 5.84, 95% CI = (- 0.01, 11.69); p = 0.05). No significant differences were found in the domain of household participation. At 16 months post-intervention, no significant differences were observed between the intervention and control groups in overall scores or any subdomain, suggesting challenges in maintaining initial improvements over time. CONCLUSIONS: The DIG programme showed short-term positive effects on social participation among ultra-poor people with disabilities, especially in societal engagement. The absence of long-term sustained improvements underscores the complexity of disability inclusion in resource-constrained settings. Future interventions should develop strategies like extended support or booster sessions to maintain initial gains. TRIAL REGISTRATION: Registry for International Development Impact Evaluations (RIDIE-STUDY-ID-626008898983a) and ISRCTN (ISRCTN-78592382)
Associated factors for dropout of first versus third doses of pentavalent vaccination in Tanzania.
Get PDFThe pentavalent is a vaccine against Diphtheria, Pertussis, Tetanus, Hepatitis B, and Haemophilus type B influenza. A child is considered a pentavalent vaccination dropout if they have received the first dosage as advised but have not obtained the third dose. In Tanzania, the first-dose receiver of pentavalent was approximately 97 %, whereas only 89 % received a third dose. Unfortunately, no studies have been done in Tanzania to evaluate the factors at the national level that are linked with first-versus third-dose pentavalent vaccine dropout; hence, we explored these factors here for the first time. A cross-sectional survey of randomly selected households was conducted. The sample size was calculated to provide overall, age- and sex-specific coverage estimates for measles-rubella vaccine evaluation among children aged between 9 and 59 months at the national level, as explained elsewhere. The fieldwork activities were done for one month from November to December 2019 for both Zanzibar and Tanzania Mainland. A total of 4460 caregivers of children aged 12-23 months were interviewed for routine immunization services, and a total of 4403 caregivers were included in this analysis of the uptake of the pentavalent vaccine. The number of children who received the first dose of the pentavalent vaccine was 4020 (91.5 %), while the number of children who received the third dose of the pentavalent vaccine was 3915 (89.4 %). The overall pentavalent vaccination dropout rate was 2.3 %. The rate was lower in Zanzibar (0.9 %) than in the Tanzanian mainland (2.4 %). Wealth quintile, sex of caregivers, and education were factors significantly associated with the pentavalent-3 dropout rate among children aged 12-23 months in Tanzania. Our results provide strong support for further efforts to improve current vaccination coverage to optimize the use of prioritized, timely, and appropriate interventions at the regional and district levels and to improve the health education given to expectant women during their clinic visits so they may comprehend the value of routine immunization
Primary prevention in hospitals in 20 high-income countries in Europe - A case of not "Making Every Contact Count"?
Get PDFThis article provides a snapshot of primary prevention activities in hospitals in 20 European high-income countries, based on inputs from experts of the Observatory's Health Systems and Policies Monitor (HSPM) network using a structured questionnaire. We found that in the vast majority of countries (15), there are no systematic national policies on primary prevention in hospitals. Five countries (Cyprus, Finland, Ireland, Romania and the United Kingdom) reported systematic primary prevention activities in hospitals, although in one of them (Cyprus) this was due to the fact that small hospitals in rural areas or less populated districts host providers of primary care. In two of the five countries with systematic national policies on primary prevention, there are no incentives (financial or otherwise) to provide these interventions. The remaining three countries (Finland, Romania and the United Kingdom) report the existence of incentives, but only two of them (Romania and the United Kingdom) provide financial incentives in the form of additional funding. Only two of the 20 countries (Ireland and the United Kingdom) make explicit use of the Making Every Contact Count (MECC) approach. Overall, it can be concluded that there is little focus on primary prevention in hospitals in Europe, which may be seen as a missed opportunity