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Successful Tuberculosis Treatment Outcomes among HIV/TB Coinfected Patients Down-Referred from a District Hospital to Primary Health Clinics in Rural South Africa.

BACKGROUND: HIV and tuberculosis (TB) coinfection remains a major public health threat in sub-Saharan Africa. Integration and decentralization of HIV and TB treatment services are being implemented, but data on outcomes of this strategy are lacking in rural, resource-limited settings. We evaluated TB treatment outcomes in TB/HIV coinfected patients in an integrated and decentralized system in rural KwaZulu-Natal, South Africa. METHODS: We retrospectively studied a cohort of HIV/TB coinfected patients initiating treatment for drug-susceptible TB at a district hospital HIV clinic from January 2

Вирус иммунодефицита человека и вирус гепатита В являются сопутствующими инфекциями среди больных туберкулезом, посещающих типовое отделение медицинских исследований в сельской местности в Гатампуре, Северная Индия.

ВВЕДЕНИЕ: Это перспективное межсекторальное исследование было проведено на базе больниц для оценки распространенности вирусов иммунодефицита человека (ВИЧ) и гепатита В (ВББ) среди пациентов с активными заболеваниями туберкулезом (ТБ) в Амбулаторном отделении (ОПД) в образцовом подразделении сельских медицинских исследований в Гатампуре, одном из сельских деревень Канпурского района. МАТЕРИАЛЫ И МЕТОДЫ: Социально-демографические характеристики и клинические характеристики больных туберкулезом анализировались в контексте симптомов во время тестирования. Состояние ВИЧ и ГБТС было определено и со

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INTRODUCTION: This prospective cross-sectional hospital-based study was carried out in order to assess the prevalence of human immunodeficiency virus (HIV) and hepatitis B virus (HBV) infections among patients with active tuberculosis (TB) disease attending an Outpatient Department (OPD) at the Model Rural Health Research Unit in Ghatampur, a rural village i…

Population-focused community-based health literacy model for high-risk people: preventing type 2 diabetes mellitus through participatory action research in rural Thailand.

BACKGROUND: Type 2 diabetes mellitus (T2DM) represents a significant public health challenge in Thailand, particularly in rural communities. Despite high prevalence rates, evidence-based, culturally appropriate prevention programs for high-risk populations remain limited. This study developed and evaluated a community-based health literacy model for T2DM prevention using participatory action research (PAR). METHODS: We conducted a four-phase PAR study in a northeast province, Thailand, from April to October 2024. Fifteen high-risk individuals (mean age 54.73 ± 9.22 years, 86.7% female) and 37

Digital stethoscope use by non-physician primary care health workers on children under five years of age in rural Bangladesh: a feasibility study.

Lung auscultation is not included in the WHO Integrated Management of Childhood Illness algorithm, partly due to concerns regarding feasibility and reliability when performed by non-physician primary health workers in low-resource settings. In this feasibility study, we evaluated whether non-physician primary care health workers (community health care providers (CHCPs)) can record quality lung sounds from children aged 2-59 months. Feasibility was predefined as more than 50% of children having quality recordings at the overall sample level. After receiving three days of structured training, ni

Physical and sexual gender-based violence research embedded within 'care as usual' sexual and reproductive health programming in rural Bolivia: a study protocol.

BACKGROUND: The global effects of gender-based violence necessitate coordinated, evidence-based efforts across scientific and programmatic communities of practice. Transparent accounting of protocol implementation serves as a critical mechanism for knowledge scaffolding and fostering iterative learning, methodological refinement, and accountability. Our study purpose was to establish baseline prevalence and descriptive characteristics of physical and sexual gender-based violence experienced by adolescent and emerging adult women living in rural, resource-variable settings in Eastern Bolivia. W

Emergency obstetric and newborn care in conflict-affected Somalia: rural access inequities, referral barriers, and health-system priorities - a policy and practice review.

Emergency obstetric and newborn care remains a critical maternal-health and health-system priority for reducing preventable maternal and neonatal deaths in Somalia. Prolonged conflict, displacement, recurrent climate shocks, poverty, and rural access inequities continue to expose pregnant women and newborns to delays in reaching timely emergency care. Although previous reviews have described broad maternal and newborn health challenges in Somalia, less attention has been given to how emergency obstetric and newborn care gaps interact with rural geography, insecurity, referral barriers, workfor

Severe Mental Health Conditions, Fentanyl Injection, and Severe Substance Use Disorders Are Associated with Violent Victimization Among Rural Appalachian Adults Who Inject Drugs.

Background: Despite evidence linking polyvictimization (i.e. two or more violence types such as physical assault and at least one adverse childhood experience) to substance use and mental health issues among people who inject drugs (PWID), research on its association with mental health, substance use, and socio-demographic factors among PWID remains limited.Objectives: We examined socio-demographics, mental health, and substance use factors associated with lifetime polyvictimization among PWID, focusing mainly on violent victimization, irrespective of perpetration/offending.Methods: We utilize

Odor nuisance, environmental impact and health risk of priority-controlled VOCs generated from three decentralized aerobic biological modes in treating rural perishable waste.

Utilization of perishable waste has emerged as the pivotal factor in enhancing the quality and efficiency of garbage classification in rural regions of China. Nevertheless, the operation of small-scale decentralized aerobic biological treatment facilities in rural areas will inevitably result in the emission of malodorous volatile organic compounds (VOCs). In this study, VOCs emission characteristics of three typical decentralized facilities for the treatment of perishable waste in rural areas were investigated using cold trap enrichment combined with gas chromatography and mass spectrometry t

HMG Co-A reductase inhibitor medication management in American Indians with type 2 diabetes: A multiyear view from a rural tribal health system.

BACKGROUND: American Indian peoples have the highest prevalence of diabetes among all racial and ethnic groups. Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality in people with type 2 diabetes. Lipid management, including statin medications, is recommended to reduce the risk of ASCVD for patients with type 2 diabetes. OBJECTIVES: We described statin medication dispensing patterns and analyzed adherence trends by age group and intensity of statin therapy within the Choctaw Nation Health Services Authority (CNHSA) type 2 diabetes patient population.

Experiences of membership in munno mubulwadde (your friend indeed) - a novel community-based health insurance scheme in Luwero district in rural central Uganda.

BACKGROUND: Community-Based Health Insurance (CBHI) schemes are recognized as an important health financing pathway to achieving universal health coverage (UHC). Although previous studies have documented CBHIs in low-income countries, the majority of these have been provider-based. Non-provider based schemes have received comparatively less empirical attention. We sought to describe a novel non-provider based CBHI munno mubulwadde (your friend indeed) comprising informal sector members in rural central Uganda to understand the structure of the scheme, the experiences of scheme members in terms

mHealth-community health worker telemedicine intervention for surgical site infection diagnosis: a prospective study among women delivering via caesarean section in rural Rwanda.

BACKGROUND: Surgical site infections (SSIs) cause a significant global public health burden in low and middle-income countries. Most SSIs develop after patient discharge and may go undetected. We assessed the feasibility and diagnostic accuracy of an mHealth-community health worker (CHW) home-based telemedicine intervention to diagnose SSIs in women who delivered via caesarean section in rural Rwanda. METHODS: This prospective cohort study included women who underwent a caesarean section at Kirehe District Hospital between September 2019 and March 2020. At postoperative day 10 (±3 days), a tr

Women's empowerment, intrahousehold influences, and health system design on modern contraceptive use in rural Mali: a multilevel analysis of cross-sectional survey data.

BACKGROUND: Persistent challenges in meeting reproductive health and family planning goals underscore the value in determining what factors can be leveraged to facilitate modern contraceptive use, especially in poor access settings. In Mali, where only 15% of reproductive-aged women use modern contraception, understanding how women's realities and health system design influence contraceptive use helps to inform strategies to achieve the nation's target of 30% by 2023. METHODS: Using household survey data from the baseline round of a cluster-randomized trial, including precise geolocation data

Prevalence and determinants of modern contraceptive utilization among rural lactating mothers: findings from the primary health care project in two northwest Ethiopian districts.

BACKGROUND: Contraceptive utilization is a guarantee to avert unwanted pregnancies. In Ethiopia however, more than half of the rural women have shorter birth intervals. Consequently, 17 and 8% of the births have been either mistimed (wanted at later date) or unwanted, respectively. Therefore, this study investigated modern contraceptive utilization and its predictors among rural lactating women. METHODS: A community based-cross-sectional study was conducted from May 01 to June 29, 2019, in Dabat and Gondar zuria districts, northwest Ethiopia. Data from 603 lactating mother were collected thro

Effect of A Community Health Worker led Intervention on Skilled Birth Care in Rural Mwingi West Sub-County, Kenya: A Quasi Experimental Study.

Despite strong evidence that skilled birth care (SBC) significantly reduces maternal deaths, one in four babies worldwide are delivered without SBC. This has kept maternal mortality rates (MMR) high in sub-Saharan Africa and Kenya in particular. Kenya adopted Community Health Strategy (CHS) with the aim of improving community health services. The aim of this study was to evaluate the effect of CHS on SBC in Mwingi west sub-county, Kenya. A quasi experimental study design was conducted with 1 pretest and 2 post-test household surveys done in intervention and control sites. Sample size in each s

Varying high levels of faecal carriage of extended-spectrum beta-lactamase producing Enterobacteriaceae in rural villages in Shandong, China: implications for global health.

Antibiotic resistance is considered a major threat to global health and is affected by many factors, of which antibiotic use is probably one of the more important. Other factors include hygiene, crowding and travel. The rapid resistance spread in Gram-negative bacteria, in particular extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae (ESBL-E), is a global challenge, leading to increased mortality, morbidity and health systems costs worldwide. Knowledge about resistance in commensal flora is limited, including in China. Our aim was to establish the faecal carriage rates of ESB

Road map to scaling-up: translating operations research study's results into actions for expanding medical abortion services in rural health facilities in Nepal.

BACKGROUND: Identifying unsafe abortion among the major causes of maternal deaths and respecting the rights to health of women, in 2002, the … od quality by the service providers and the women who received medical abortion services from these rural health facilities. CONCLUSIONS: This research provided further evidence and a road-map for expanding medical abortion services to rural areas by mid-level service providers in minimum clinical settings without the oversight of physicians, thus reducing co …

Deaths ascribed to non-communicable diseases among rural Kenyan adults are proportionately increasing: evidence from a health and demographic surveillance system, 2003-2010.

BACKGROUND: Non-communicable diseases (NCDs) result in more deaths globally than other causes. Monitoring systems require strengthening to attribute the NCD burden and deaths in low and middle-income countries (LMICs). Data from health and demographic surveillance systems (HDSS) can contribute towards this goal. METHODS AND FINDINGS: Between 2003 and 2010, 15,228 deaths in adults aged 15 years (y) and older were identified retrospectively using the HDSS census and verbal autopsy in rural western Kenya, attributed into broad categories using InterVA-4 computer algorithms; 37% were ascribed to

Implementing transnational telemedicine solutions: a connected health project in rural and remote areas of six Northern Periphery countries Series on European collaborative projects.

This is the first article in a Series on collaborative projects between European countries, relevant for general practice/family medicine an … Telemedicine Solutions' (ITTS) project from September 2011 to December 2013, led by the Centre for Rural Health in Inverness, Scotland. Ten sustainable projects based on videoconsultation (speech therapy, renal services, emergency psychiatry, diabetes), mobile patient self-management (physical activity, diabetes, inflammatory bowel disease) and home-based hea …

Effect of a community-based child health counselling intervention on health-seeking behaviours, complementary feeding and nutritional condition among children aged 6-23 months in rural China: A pre- and post-comparison study.

In China, the prevalence of undernutrition among children under 5 years of age has declined significantly during recent decades. However, noticeable gaps exist between rural and urban areas. Since 2012, a government-funded nutrition programme, Ying Yang Bao (YYB; soybean powder-based iron-rich supplement) programme, has been implemented in poor rural areas to decrease the risk of developing anaemia among children aged 6-23 months, but there are still inadequate health care awareness, feeding knowledge and skills among caregivers. From June 2018 to December 2020, a child health counselling inte